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NPI Code Detail

MEDICARE: DR. DOUGLAS PAUL CALDWELL M.D.

MEDICARE: DR. DOUGLAS PAUL CALDWELL 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
12085R0202XDiagnostic Radiology PhysicianMD00042409WA
22085R0202XDiagnostic Radiology Physician12348ID
32085R0202XDiagnostic Radiology Physician64827MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2172345OTHERWAL&I PROVIDER NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4184435OTHERWAL&I PROVIDER NUMBER
5172074OTHERWAL&I PROVIDER NUMBER

General Provider Information

NPI Number : 1982682209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS PAUL CALDWELL M.D.
Provider Business Mailing Address
First Line : 7595 ANAGRAM DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7399
Country : US
Telephone Number : 612-573-2200
Fax Number : 612-573-2274
Provider Business Practice Location Address
First Line : 7595 ANAGRAM DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7399
Country : US
Telephone Number : 612-573-2200
Fax Number : 612-573-2274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 07/13/2022

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