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General NPI Number Information
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NPI Number | 1891766804
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Entity Type | Individual
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Provider Name | DIRK J VAN OPPEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1965 FORD PKWY
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City | SAINT PAUL
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State | MN
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Zip | 55116-1923
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Country | US
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Telephone | 651-698-2406
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 LIST PL
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-4559
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Country | US
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Telephone | 612-924-9433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 17443
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4538
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License Number State | SD
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