Provider Demographics
NPI:1477556207
Name:DURANT, DANIEL THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:THOMAS
Last Name:DURANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:STE 2000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2708
Mailing Address - Country:US
Mailing Address - Phone:612-338-4861
Mailing Address - Fax:612-333-8306
Practice Address - Street 1:4001 STINSON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-3488
Practice Address - Country:US
Practice Address - Phone:612-788-1621
Practice Address - Fax:612-788-8079
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN23970207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP13204OtherHEALTHPARTNERS
MN187004OtherPREFERRED ONE
MN0800038OtherMEDICA PRIMARY
FM101212C757OtherUCARE
MN200002101436OtherMETROPOLITAN HEALTH PLAN
MN636090400Medicaid
MN080161OtherSELECTCARE
MN0801616OtherMEDICA
MN7D638DUOtherBLUE SHIELD
MN1021630001OtherADMINISTAR FEDERAL
MN636090400Medicaid
MN1021630001OtherADMINISTAR FEDERAL
MN080161OtherSELECTCARE