MEDICARE: DR. BRADLEY ROGER HELTEMES 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
1	207R00000X	Internal Medicine Physician	030112-3	MN

General Provider Information

NPI Number	:	1902974918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY ROGER HELTEMES M.D.

Provider Business Mailing Address
First Line	:	5145 MORGAN AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55419-1025
Country	:	US
Telephone Number	:	612-922-3473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 AMERIPRISE FINANCIAL CTR
Second Line	:	S7
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55474-0011
Country	:	US
Telephone Number	:	612-671-3642
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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