Individual
DR. JOHN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 516 DELAWARE STREET SE, PWB FOURTH FLOOR, ROOM 4-100, MINNEAPOLIS, MN 55455
(612) 672-7122
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MMC 94, MINNEAPOLIS, MN 55455
(612) 626-2755
(612) 626-2467
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
24910
MN
2080P0202X
Pediatric Cardiology Physician
Primary
24910
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055641
—
MT
01
—
0644007
PREFERRED ONE
MN
01
—
101002
UCARE
MN
05
—
10383
—
ND
05
—
1984401
—
IA
01
—
25-22585
MEDICA CHOICE
MN
01
—
2570708
MEDICA PRIMARY
MN
05
—
276893300
—
MN
01
—
2T119BA
BCBS
MN
05
—
30259200
—
WI
01
—
604547
ARAZ
MN
05
—
805361700
—
ID
01
—
HP12862
HEALTHPARTNERS
MN
05
—
JB40370
—
RI
Enumeration date
06/22/2006
Last updated
07/28/2009
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