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NPI Code Detail

MEDICARE: DR. JUSTIN KYLE HALBE MD

MEDICARE: DR. JUSTIN KYLE HALBE MD
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
1207RC0000XCardiovascular Disease Physician0438840KS
2207RC0000XCardiovascular Disease Physician63322MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2068002381OTHERKSMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356667984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN KYLE HALBE MD
Provider Business Mailing Address
First Line : 1690 UNIVERSITY AVE W STE 370
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-3723
Country : US
Telephone Number : 651-232-5321
Fax Number :
Provider Business Practice Location Address
First Line : 1390 UNIVERSITY AVE W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-4001
Country : US
Telephone Number : 651-232-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2010
Last Update Date : 01/18/2024

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