Individual
CHARLES B DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7505 METRO BLVD STE 400, EDINA, MN 55439
(612) 573-2200
(612) 573-2274
Mailing address
7505 METRO BLVD STE 400, EDINA, MN 55439-3010
(612) 573-2200
(612) 573-2274
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
48603
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0721050
—
IA
01
—
1046956
PREFERRED ONE
MN
01
—
133042
UCARE
MN
01
—
16-04146
MEDICA
MN
01
—
2443230
AMERICA'S PPO
MN
01
—
252817
MIDLANDS CHOICE INC
MN
05
—
34864100
—
WI
01
—
505P3DO
BLUE CROSS BLUE SHIELD
MN
05
—
621966700
—
MN
01
—
9103415
PHCS/MULTIPLAN
MN
01
—
99112184
WI HEALTH INSURANCE RISK SHARING PLAN
WI
01
—
HP63008
HEALTHPARTNERS
MN
01
—
P00327697
RAILROAD MEDICARE WI
WI
01
—
P00327700
RAILROAD MEDICARE MN
MN
Enumeration date
05/09/2006
Last updated
06/28/2018
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