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Individual

DR. PETER JAMES HALVORSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4946
(763) 572-5710
(763) 586-5888
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 572-5710
(763) 571-3008

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
47931
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1044101
PREFERRED ONE
MN
05
125173200
MN
01
132905
UCARE MN
MN
01
1701444
MEDICA
MN
01
2365755
AMERICA'S PPO
MN
01
488K8HA
BCBS OF MN
MN
01
7533292
AETNA
MN
01
HP53178
HEALTHPARTNERS
MN
Enumeration date
04/10/2006
Last updated
04/10/2012
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