Individual
DR. MICHELLE MARIE DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
420 DELAWARE STREET SE, 760 MAYO MEMORIAL BUILDING, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-0622
(612) 626-2696
Mailing address
420 DELAWARE STREET SE, MMC 669 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-0622
(612) 626-2696
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
42857
MN
207SG0203X
Clinical Molecular Genetics Physician
Primary
42857
MN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
42857
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009A5DO
BCBS
MN
01
—
1025646
PREFERRED ONE
MN
01
—
11-00106
MEDICA CHOICE & PRIMARY
MN
01
—
1131521
ARAZ
MN
01
—
140155
UCARE
MN
05
—
160147400
—
MN
01
—
HP41076
HEALTHPARTNERS
MN
Enumeration date
07/05/2006
Last updated
05/11/2012
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