Individual
DR. JOHAN SEPTIMUS BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E SUPERIOR ST, SUITE L201, DULUTH, MN 55802-2207
(218) 249-3057
Mailing address
1001 E SUPERIOR ST, SUITE L201, DULUTH, MN 55802-2207
(218) 249-3057
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31523
MN
207RI0200X
Infectious Disease Physician
Primary
31523
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
661088900
—
MN
Enumeration date
05/10/2006
Last updated
03/29/2016
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