Provider Demographics
NPI:1114014578
Name:HUNTER, DAVID W (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-273-6004
Mailing Address - Fax:
Practice Address - Street 1:7505 METRO BLVD STE 400
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3010
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN217622085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2T406HUOtherBLUE CROSS BLUE SHIELD
MN1622536OtherMEDICA-CHOICE
MN16-02032OtherMEDICA-PRIMARY
300072659OtherRR MEDICARE
MN457373100Medicaid
MNHP21393OtherHEALTH PARTNERS
MT0051340Medicaid
MN124377OtherU CARE
595910OtherARAZ
MN080010OtherFAIRVIEW
MN1010325OtherPREFERRED ONE
IA1998195Medicaid
300072659OtherRR MEDICARE