Organization
MINNEAPOLIS CLINIC OF NEUROLOGY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HAUGEN HOROWITZ M.D. (PRESIDENT)
(763) 302-4114
Entity
Organization
Contact information
Practice address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 588-0661
(763) 287-2310
Mailing address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 588-0661
(763) 287-2310
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100273
UCARE CLINIC #
MN
01
—
11651MI
BCBS OF MN PROVIDER #
MN
05
—
32833200
—
WI
05
—
784810200
—
MN
01
—
96287
PREFERRED ONE CLINIC #
MN
Enumeration date
07/11/2006
Last updated
12/02/2009
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