MEDICARE: PAUL D. DINGMAN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0013X	Independent Medical Examiner Chiropractor	2701	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44-82648	OTHER	MN	MEDICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	71229-NO	OTHER	MN	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1205115912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL D. DINGMAN PA

Provider Business Mailing Address
First Line	:	3984 CENTRAL AVE NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3931
Country	:	US
Telephone Number	:	763-788-9101
Fax Number	:	763-789-4980

Provider Business Practice Location Address
First Line	:	3984 CENTRAL AVE NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3931
Country	:	US
Telephone Number	:	763-788-9101
Fax Number	:	763-789-4980

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. PAUL D DINGMAN
Credential	:	PD
Telephone Number	:	763-788-9101

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	11/09/2011

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