Provider Demographics
NPI:1477641066
Name:KATZ, HARRY IRVING (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:IRVING
Last Name:KATZ
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 1:420 DELAWARE ST SE MM 98
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-625-5656
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE STREET S.E.
Practice Address - Street 2:PWB FIFTH FLOOR, CLINIC 5A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-625-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15870207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0377009OtherPREFERRED ONE
MN120988OtherU CARE
WI31329600OtherWISCONSIN MEDICAID
MN03-00131OtherMEDICA-CHOICE
MI068A2KAOtherBLUE CROSS BLUE SHIELD
MNHP13661OtherHEALTH PARNTERS
IA0505339OtherIOWA MEDICAID
MN03-00010OtherMEDICA-PRIMARY
768186OtherARAZ
MN095414OtherFAIRVIEW
MN0377009OtherPREFERRED ONE