Individual
DR. MADELINE HALLIE GARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15535 34TH AVE N, PLYMOUTH, MN 55447-1481
(763) 473-1480
(763) 473-1480
Mailing address
18315 5TH AVE N, PLYMOUTH, MN 55447-3310
(763) 473-1480
(763) 473-1480
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33996
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131146
UCARE
MN
01
—
1701615
MEDICA
MN
01
—
819471011592
PREFERRED ONE
MN
05
—
854807200
—
MN
01
—
86G05GA
BLUECROSS
MN
01
—
HP13342
HEALTH PARTNERS
MN
Enumeration date
06/03/2006
Last updated
02/03/2016
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