Tate, Douglas

Tate, Douglas is an individual health care provider with primary practice located at 6545 France Ave S Suite 400, Edina MN 55435-2131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Tate, Douglas can be contacted via phone (952) 920-9191.

Contact Information

Primary practice address
6545 France Ave S Suite 400 Edina MN 55435-2131
Phone: (952) 920-9191
Fax: (952) 920-0232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 26159 Minnesota

Profile Details

NPI number 1659395283
LBN Legal business name Tate, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659395283 NPPES
Minnesota Other 17682TA BLUE CROSS BLUE SHIELD
Minnesota Other CP9020830005 BLUE CROSS BLUE SHIELD
Minnesota Other 1202983 BLUE CROSS BLUE SHIELD

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