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Individual
PAUL L HENDRICKSON
Active
Individual
PAUL L HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032152
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106054
MEDICA #
MN
01
—
0106545
MEDICA #
MN
01
—
10440
NDBS #
MN
01
—
108034
UCARE #
MN
05
—
16005
—
MN
01
—
2223
SIOUX VALLEY #
MN
01
—
28232HE
MNBS #
MN
05
—
300793600
—
MN
01
—
901108
AMERICA'S PPO/ARAZ #
MN
01
—
DA9031015654
PREFERRED ONE #
MN
01
—
HP19489
HEALTHPARTNERS #
MN
01
—
MN1000020
LHS/BANNERHEALTH #
MN
Enumeration date
06/08/2006
Last updated
11/21/2011
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