Individual
DAVID T LOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4444
(612) 863-1169
Mailing address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(651) 635-9173
(651) 628-2999
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301073577
MI
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
4301073577
MI
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
57816
MN
390200000X
Student in an Organized Health Care Education/Training Program
43921
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548278013
—
MI
01
—
930106270
RAILROAD MEDICARE
MI
01
—
DL073577
BCBS
MI
Enumeration date
08/03/2006
Last updated
10/30/2020
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