Provider Demographics
NPI:1093757338
Name:MINN, HMU (MD)
Entity Type:Individual
Prefix:DR
First Name:HMU
Middle Name:
Last Name:MINN
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:PO BOX 418953
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:STE 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64203207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410952000Medicaid
MD7239909OtherGBMC AETNA NON HMO
MDS1380106OtherGBMC CAREFIRST REGIONAL
MD309479OtherGBMC AMERIGROUP
MD8154700OtherGBMC MAMSI
MD0844590OtherGBMC CIGNA
MDKJ15-P17181OtherGBMC CAREFIRST POS
MD1386606OtherGBMC AETNA HMO
MD260728OtherGBMC KAISER PERM
MDKJ15GB-89054001OtherGBMC CAREFIRST MD
MD0412527OtherGBMC UHC AMERICHOICE
MD203639OtherGBMC HOPKINS PRODUCTS
MD7239909OtherGBMC AETNA NON HMO
MDKJ15GB-89054001OtherGBMC CAREFIRST MD
MD0412527OtherGBMC UHC AMERICHOICE
MD712L/188786YBPGMedicare PIN