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1396717500

NPI Code Detail

MEDICARE: DAVID LEE ESTRIN MD

MEDICARE: DAVID LEE ESTRIN 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
1	208000000X	Pediatrics Physician	23034	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1201556	OTHER	MN	MEDICA
2	100450	OTHER	MN	UCARE
3	04297ES	OTHER	MN	BLUE CROSS
4	CP9040844003	OTHER	MN	PREFERRED ONE

General Provider Information

NPI Number	:	1396717500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LEE ESTRIN MD

Provider Business Mailing Address
First Line	:	17705 HUTCHINS DR
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-4145
Country	:	US
Telephone Number	:	952-401-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	17705 HUTCHINS DR
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-4145
Country	:	US
Telephone Number	:	952-401-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/09/2007

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Directions to “ DAVID LEE ESTRIN MD” Practice Location

Language	Start Address	Practice Location

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