Individual
CARL W HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17629
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406274
MEDICA
—
01
—
27G34HA
BLUE CROSS MN FACILITY
MN
05
—
31162400
—
WI
01
—
64Q26HA
BLUE CROSS MN PRO FEE
MN
01
—
HP10546
HEALTHPARTNERS
—
01
—
NA9030224004
PREFERREDONE
—
Enumeration date
08/31/2006
Last updated
07/08/2007
Update your record
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