BRADLEY M DOEDEN MD NPI 1780644047

NPI Information

NPI: 1780644047
Provider Name: BRADLEY M DOEDEN, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
7701 YORK AVE S
SUITE 180
EDINA, MN
ZIP 55435
Phone: (952) 927-7810
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Bradley M Doeden, MD is a specialist in Edina, MN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Bradley M Doeden, MD NPI is 1780644047. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7701 YORK AVE S
SUITE 180
EDINA, MN
ZIP 55435-845
Phone: (952) 927-7810
Fax: (952) 927-6309

The enumeration date for this NPI number is 3/23/2006 and was last updated on 5/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		27594	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3311337	OTHER	MINNESOTA	MEDICA CHOICE
2	410999025	OTHER	MINNESOTA	TRICARE
3	53966DO	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
4	A95919	MEDICARE UPIN
5	960540799002	OTHER	MINNESOTA	PREFERRED ONE
6	20999	OTHER	MINNESOTA	AMERICAS PPO
7	HP13175	OTHER	MINNESOTA	HEALTH PARTNERS
8	0256006	OTHER	MINNESOTA	SELECT CARE
9	107109C626	OTHER	MINNESOTA	UCARE
10	109127	OTHER	MINNESOTA	PATIENT CHOICE
11	3300003	OTHER	MINNESOTA	MEDICA PRIMARY
12	460000009	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
13	110034146	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	RAILROAD MEDICARE
14	616282700	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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