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
Fax: (651) 772-5477
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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