Individual
NEIL C HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2904 JOHNSON ST NE, MINNEAPOLIS, MN 55418-2234
(612) 788-0900
(612) 788-4930
Mailing address
2904 JOHNSON ST NE, MINNEAPOLIS, MN 55418-2234
(612) 788-0900
(612) 788-4930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19172
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00687002
PREFERRED ONE
MN
01
—
0111978
MEDICA
MN
01
—
080161602
RAILROAD MEDICARE
MN
01
—
103052
UCARE
MN
01
—
55B82HE
BLUES
MN
05
—
637877300
—
MN
01
—
80483
HEALTHPARTNERS
MN
Enumeration date
01/15/2007
Last updated
07/09/2007
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