Individual
HANS CARL BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1645 LYNDALE AVE N STE 103, FARIBAULT, MN 55021-2935
(651) 968-5201
(651) 968-5904
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5201
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
56806
MN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35.099051
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
45459
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043499577
MMSI
MN
05
—
1043499577
—
MN
01
—
56806
MINNESOTA MEDICAL LICENSE
MN
Enumeration date
11/01/2007
Last updated
07/21/2022
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