Individual
DR. SANDRA LOUISE HYVARINEN DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6109 W 105TH ST, BLOOMINGTON, MN 55438-1833
(952) 831-5522
(952) 831-0381
Mailing address
6109 W 105TH ST, BLOOMINGTON, MN 55438-1833
(952) 831-5522
(952) 831-0381
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
29543
MN
208000000X
Pediatrics Physician
29543
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2034451
—
MN
Enumeration date
01/30/2007
Last updated
09/17/2013
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