MEDICARE: SOLVEIG A HANSEN 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	207Q00000X	Family Medicine Physician	32491	MN

General Provider Information

NPI Number	:	1992753073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLVEIG A HANSEN MD

Provider Business Mailing Address
First Line	:	98 DUNBAR WAY
Second Line	:
City	:	MAHTOMEDI
State	:	MN
Zip	:	55115-2810
Country	:	US
Telephone Number	:	651-773-5864
Fax Number	:

Provider Business Practice Location Address
First Line	:	724 19TH AVE N
Second Line	:
City	:	SOUTH ST PAUL
State	:	MN
Zip	:	55075-1301
Country	:	US
Telephone Number	:	651-232-6348
Fax Number	:	651-232-6127

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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