Head, Michael Douglas
Head, Michael Douglas is an individual health care provider with primary practice located at 5922 Lexington Ave N , Shoreview MN 55126-5604. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Head, Michael Douglas can be contacted via phone (651) 784-3396.Contact Information
Primary practice address
5922 Lexington Ave N
Shoreview MN 55126-5604
Phone: (651) 784-3396
Fax: (651) 784-7247
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3281 | Minnesota |
Profile Details
| NPI number | 1801811880 |
|---|---|
| LBN Legal business name | Head, Michael Douglas |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Feb 10th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801811880 | NPPES |
| Minnesota | Other | 231934 | CCMI ID |
| Minnesota | Other | 35P22WI | CCMI ID |
| Minnesota | MEDICAID | 7711328-00 | CCMI ID |
| Minnesota | Other | 4400056 | CCMI ID |
| Minnesota | Other | 79279 | CCMI ID |
| Minnesota | Other | 35P23HE | CCMI ID |
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