Provider Demographics
NPI:1205857380
Name:HYSER, CRAIG L (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:L
Last Name:HYSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-884-0649
Mailing Address - Fax:
Practice Address - Street 1:360 SHERMAN ST
Practice Address - Street 2:SUITE 350
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2564
Practice Address - Country:US
Practice Address - Phone:651-291-1559
Practice Address - Fax:651-291-0051
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN343982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6173523600Medicaid
CO1550Medicare ID - Type Unspecified
MN6173523600Medicaid