MEDICARE: JOHN C HULBERT 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	208800000X	Urology Physician	28070	MN

General Provider Information

NPI Number	:	1881608917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C HULBERT MD

Provider Business Mailing Address
First Line	:	6363 FRANCE AVE S
Second Line	:	SUITE 500
City	:	EDINA
State	:	MN
Zip	:	55435-2129
Country	:	US
Telephone Number	:	952-920-7660
Fax Number	:	952-920-2049

Provider Business Practice Location Address
First Line	:	6363 FRANCE AVE S
Second Line	:	SUITE 500
City	:	EDINA
State	:	MN
Zip	:	55435-2129
Country	:	US
Telephone Number	:	952-920-7660
Fax Number	:	952-920-2049

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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