Detert, David G

Detert, David G is an individual health care provider with primary practice located at 1705 N Highway 20 , Cannon Falls MN 55009-1187. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Detert, David G can be contacted via phone (507) 288-3443.

Contact Information

Primary practice address
1705 N Highway 20 Cannon Falls MN 55009-1187
Fax: (507) 529-6622
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23504 Minnesota

Profile Details

NPI number 1902872641
LBN Legal business name Detert, David G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Mar 4th, 2014 - about 10 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 1902872641 NPPES
Minnesota MEDICAID 467805200

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