Provider Demographics
NPI:1497868368
Name:TORTORELIS, DEAN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:GEORGE
Last Name:TORTORELIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6525 FRANCE AVE S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2148
Mailing Address - Country:US
Mailing Address - Phone:952-927-6501
Mailing Address - Fax:952-653-1435
Practice Address - Street 1:6525 FRANCE AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2148
Practice Address - Country:US
Practice Address - Phone:952-927-6501
Practice Address - Fax:952-653-1435
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN40181208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1900010OtherMEDICA PRIMARY
1900383OtherMEDICA CHOICE
MN020052983OtherRAILROAD MEDICARE
1675646OtherARAZ PPO
MN880217300Medicaid
WI82715000Medicaid
01014791OtherPREFERRED ONE
169560C118OtherUCARE
139T2TOOtherBLUE CROSS
IA1497868368Medicaid
HP23651OtherHEALTHPARTNERS
G60335OtherWAUSAU
MN020052983Medicare PIN
1900383OtherMEDICA CHOICE