Hollerud, John Robert

Hollerud, John Robert is an sole proprietor health care provider with primary practice located at 11107 Ulysses St Ne Ste 100 , Blaine MN 55434-4264. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Hollerud, John Robert can be contacted via phone (763) 333-7733.

Contact Information

Primary practice address
11107 Ulysses St Ne Ste 100 Blaine MN 55434-4264
Fax: (763) 333-7711
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 36159 Minnesota

Profile Details

NPI number 1942317888
LBN Legal business name Hollerud, John Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Jun 30th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942317888 NPPES
Minnesota MEDICAID 895363500

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