Individual
YVONNE MARIE DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
424 HARVARD ST SE, SUITE M-100, MINNEAPOLIS, MN 55455-0362
(612) 625-5411
Mailing address
420 DELAWARE ST SE, MMC 480, MINNEAPOLIS, MN 55455-0341
(612) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48595
MN
207RH0000X
Hematology (Internal Medicine) Physician
Primary
48595
MN
207RX0202X
Medical Oncology Physician
48595
MN
Other
Enumeration date
07/26/2006
Last updated
10/25/2012
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