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Individual

JOHN HICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
153 CESAR CHAVEZ ST, W. ST. PAUL, MN 55107-2226
(651) 222-1816
(651) 222-1305
Mailing address
153 CESAR CHAVEZ ST, W. ST. PAUL, MN 55107-2226
(651) 222-1816
(651) 222-1305

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18813
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111858
UCARE
MN
01
1200583
MEDICA
MN
05
122288100
MN
01
32T71HI
BCBS
MN
01
HP16392
HEALTH PARTNERS
MN
Enumeration date
03/24/2006
Last updated
04/22/2013
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