Harstad, Mitchell Dean
Harstad, Mitchell Dean is an individual health care provider with primary practice located at 2055 15Th St N , Saint Cloud MN 56303-1747. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Harstad, Mitchell Dean can be contacted via phone (320) 251-1432.Contact Information
Primary practice address
2055 15Th St N
Saint Cloud MN 56303-1747
Phone: (320) 251-1432
Fax: (320) 251-7122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1982 | Minnesota |
Profile Details
| NPI number | 1396733143 |
|---|---|
| LBN Legal business name | Harstad, Mitchell Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1396733143 | NPPES |
| Minnesota | Other | 11967HA | BLUE CROSS |
| Minnesota | Other | 2211983 | BLUE CROSS |
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