Individual
DR. JON SCOTT HALLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 S 2ND ST STE A, UNIVERSITY OF MINNESOTA PHYSICIANS-MILL CITY CLINIC, MINNEAPOLIS, MN 55415-2123
(612) 338-1383
Mailing address
420 DELAWARE ST SE,, MMC 381 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 624-2622
(612) 624-5930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36295
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059A0HA
BCBS
MN
01
—
1008966
PREFERRED ONE
MN
01
—
102652
UCARE
MN
01
—
21741
ARAZ
MN
05
—
955325800
—
MN
01
—
HP20043
HEALTHPARTNERS
MN
Enumeration date
07/10/2006
Last updated
09/21/2009
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