Individual
GREGORY R HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 OSBORNE RD NE, SUITE 120, FRIDLEY, MN 55432-2765
(763) 783-8582
(763) 783-8616
Mailing address
6025 LAKE RD, SUITE 200, WOODBURY, MN 55125-1712
(651) 999-6800
(651) 999-6830
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
49996
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601125100
—
MN
01
—
P00436573
RR MEDICARE
MN
Enumeration date
08/22/2006
Last updated
09/10/2013
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