Davenport, Sandra Louise Hyvarinen

Davenport, Sandra Louise Hyvarinen is an sole proprietor health care provider with primary practice located at 6109 W 105Th St , Bloomington MN 55438-1833. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is her primary health care specialty. Davenport, Sandra Louise Hyvarinen can be contacted via phone (952) 831-5522.

Contact Information

Primary practice address
6109 W 105Th St Bloomington MN 55438-1833
Phone: (952) 831-5522
Fax: (952) 831-0381
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) 207SG0201X 29543 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29543 Minnesota

Profile Details

NPI number 1912044918
LBN Legal business name Davenport, Sandra Louise Hyvarinen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Sep 17th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912044918 NPPES
Minnesota MEDICAID 2034451

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