Individual
DR. GARETH SHIGEMI HATAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
318 N MAIN ST, AUSTIN, MN 55912-3406
(507) 437-7768
(507) 437-7769
Mailing address
318 N MAIN ST, AUSTIN, MN 55912-3406
(507) 437-7768
(507) 437-7769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2189
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011297
PREFERRED ONE
MN
01
—
115713
UCARE MINNESOTA
MN
01
—
2200450
MEDICA
MN
01
—
4C069HA
BLUE CROSS BLUE SHIELD MN
MN
Enumeration date
09/20/2006
Last updated
07/08/2007
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