Provider Demographics
NPI:1326177726
Name:DISCHINGER, DENNIS BROOK (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:BROOK
Last Name:DISCHINGER
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 1:2600 29TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1537
Mailing Address - Country:US
Mailing Address - Phone:612-724-4544
Mailing Address - Fax:612-371-0289
Practice Address - Street 1:425 20TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-4400
Practice Address - Country:US
Practice Address - Phone:612-332-4973
Practice Address - Fax:612-371-0289
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP40247OtherHEALTH PARTNERS
MN01-19756OtherMEDICA
MN576A2DIOtherBCBS
MNH42241Medicare UPIN
MN80013591Medicare ID - Type Unspecified