Individual
HEATHER RAE DANCKWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
54082
MN
207Q00000X
Family Medicine Physician
Primary
54082
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699092130
BCBS
MN
01
—
1699092130
MEDICA
—
05
—
1699092130
—
MN
01
—
P00978475
RR MEDICARE
—
Enumeration date
04/23/2010
Last updated
12/12/2016
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