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NPI Code Detail

MEDICARE: DIRK J VAN OPPEN M.D.

MEDICARE: DIRK J VAN OPPEN M.D.
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
1207V00000XObstetrics & Gynecology Physician17443MN
2207V00000XObstetrics & Gynecology Physician4538SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891766804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIRK J VAN OPPEN M.D.
Provider Business Mailing Address
First Line : 3430 LIST PL
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55416-4559
Country : US
Telephone Number : 612-924-9433
Fax Number :
Provider Business Practice Location Address
First Line : 1965 FORD PKWY
Second Line :
City : SAINT PAUL
State : MN
Zip : 55116-1923
Country : US
Telephone Number : 651-698-2406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2006
Last Update Date : 03/07/2023

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