Individual
DR. JOHN JEFFREY MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 DELAWARE STREET SE, ROOM 760, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-0622
(612) 626-2696
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MMC 609, MINNEAPOLIS, MN 55455
(612) 626-0622
(612) 626-2696
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
19412
MN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
19412
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0513234
—
IA
01
—
1009234
PREFERRED ONE
—
01
—
101363
UCARE
—
01
—
11-74546
MEDICA PRIMARY
—
01
—
1122551
MEDICA CHOICE
—
01
—
2T225MC
BLUE CROSS BLUE SHIELD
—
05
—
34601900
—
WI
01
—
768254
ARAZ
—
01
—
HP22294
HEALTH PARTNERS
—
Enumeration date
11/14/2006
Last updated
09/11/2025
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