Individual
JAIDEV R BHOOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805
(218) 786-8364
Mailing address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55855
MN
207R00000X
Internal Medicine Physician
N0648
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
55855
MN
208M00000X
Hospitalist Physician
55855
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004-0018721
MEDICA
MN
05
—
1962610956
—
MN
05
—
1962610956
—
WI
05
—
1975229-01
—
TX
Enumeration date
05/21/2007
Last updated
08/06/2018
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