Provider Demographics
NPI:1336122969
Name:HAUSCHULZ, DANIEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:HAUSCHULZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1415 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3374
Practice Address - Country:US
Practice Address - Phone:952-993-7750
Practice Address - Fax:952-993-7835
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-03-08
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Provider Licenses
StateLicense IDTaxonomies
MN44714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH65069Medicare UPIN