Provider Demographics
NPI:1386655629
Name:GESENSWAY, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GESENSWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5650
Practice Address - Street 1:3250 W 66TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2528
Practice Address - Country:US
Practice Address - Phone:952-920-0970
Practice Address - Fax:952-922-1605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN37126207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP13360OtherHEALTHPARTNERS
32105200OtherWISC MEDICAID
550S5GEOtherBLUE CROSS BLUE SHIELD
969991006240OtherPREFERREDONE
901836OtherMEDICA
969991006240OtherPREFERREDONE