Individual
DR. BRYAN D DEN HARTOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 CURVE CREST BLVD W STE 104, STILLWATER, MN 55082-6181
(651) 439-8807
(651) 439-0232
Mailing address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
28013
IA
207X00000X
Orthopaedic Surgery Physician
3947
SD
207X00000X
Orthopaedic Surgery Physician
Primary
62397
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043299738
—
MN
05
—
1043299738
—
WI
Enumeration date
01/11/2006
Last updated
07/21/2022
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