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1992975791

NPI Code Detail

MEDICARE: BRETT CARLSON M.D.

MEDICARE: BRETT CARLSON 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	207RC0000X	Cardiovascular Disease Physician	53865	MN
2	207RC0000X	Cardiovascular Disease Physician	MD-53630	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1992975791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT CARLSON M.D.

Provider Business Mailing Address
First Line	:	8170 33RD AVE S # MS 21110Q
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-4516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9555 UPLAND LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4485
Country	:	US
Telephone Number	:	952-993-1440
Fax Number	:

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

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	04/17/2026

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Directions to “ BRETT CARLSON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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