Halvorsen, John
Halvorsen, John is an individual health care provider with primary practice located at 1414 Maryland Ave E Umphysicians Phalen Village Clinic, St. Paul MN 55106. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Halvorsen, John can be contacted via phone (651) 772-3461.Contact Information
Primary practice address
1414 Maryland Ave E Umphysicians Phalen Village Clinic
St. Paul MN 55106
Phone: (651) 772-3461
Fax: (651) 772-5477
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20514 | Minnesota |
Profile Details
| NPI number | 1104830595 |
|---|---|
| LBN Legal business name | Halvorsen, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Feb 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104830595 | NPPES |
| Illinois | Other | 025128 | HEALTH ALLIANCE |
| Illinois | Other | 472301 | HEALTH ALLIANCE |
| Illinois | Other | 080154707 | HEALTH ALLIANCE |
| Illinois | Other | IL01P7 | HEALTH ALLIANCE |
| Illinois | MEDICAID | 0360893132 | HEALTH ALLIANCE |
| Illinois | Other | 7215059 | HEALTH ALLIANCE |
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