Provider Demographics
NPI:1043499577
Name:BENGTSON, HANS CARL (MD)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:CARL
Last Name:BENGTSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 COMMERCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4925
Mailing Address - Country:US
Mailing Address - Phone:651-968-5201
Mailing Address - Fax:651-968-5904
Practice Address - Street 1:1645 LYNDALE AVE N STE 103
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-2935
Practice Address - Country:US
Practice Address - Phone:651-968-5201
Practice Address - Fax:651-968-5904
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099051207XX0005X
KY45459207XX0005X
MN56806207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1043499577OtherMMSI
MN1043499577OtherHUMANA
MN1043499577OtherMEDICA/SELECT CARE
MN1043499577OtherBCBS OF MN
MN56806OtherMINNESOTA MEDICAL LICENSE
MN1043499577OtherUCARE
MN1043499577OtherAMERICA'S PPO
MN1043499577Medicaid
MN1043499577OtherHEALTHPARTNERS
MN1043499577OtherPRIMEWEST
MN1043499577OtherTRPN