1639183726 NPI number — DR. MELANIE SUE MEIER BUHR D.D.S.

Table of content: DR. MELANIE SUE MEIER BUHR D.D.S. (NPI 1639183726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639183726 NPI number — DR. MELANIE SUE MEIER BUHR D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEIER BUHR
Provider First Name:
MELANIE
Provider Middle Name:
SUE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEIER
Provider Other First Name:
MELANIE
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1639183726
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1225 E 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55805-2402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-728-6445
Provider Business Mailing Address Fax Number:
218-724-7003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1225 E 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55805-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-728-6445
Provider Business Practice Location Address Fax Number:
218-724-7003
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  10952 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 820216 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP34431 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 904481008712 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 310221008712 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 04A45ME . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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