Individual
DANIEL J WEISDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, STRPWB FIFTH FLOOR, SUITE 5-100, CLINIC 5B, MINNEAPOLIS, MN 55455
(612) 626-2663
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414-2924
(612) 884-0649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24529
MN
207RH0000X
Hematology (Internal Medicine) Physician
24529
MN
207RH0003X
Hematology & Oncology Physician
Primary
24529
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055318
—
MT
01
—
090837
FAIRVIEW
MN
01
—
100792
UCARE
MN
01
—
1009350
PREFERREDONE
MN
01
—
2T191WE
BLUE CROSS BLUE SHIELD
MN
01
—
3600013
MEDICA - PRIMARY
MN
01
—
3624556
MEDICA - CHOICE
MN
01
—
604611
ARAZ
MN
05
—
884802500
—
MN
01
—
HP22084
HEALTHPARTNERS
MN
Enumeration date
09/20/2006
Last updated
10/29/2012
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