Provider Demographics
NPI:1497989214
Name:HOTUJEC, ALLISON R (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:R
Last Name:HOTUJEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11269 JEFFERSON HWY N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3123
Mailing Address - Country:US
Mailing Address - Phone:763-236-0600
Mailing Address - Fax:
Practice Address - Street 1:11269 JEFFERSON HWY N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3123
Practice Address - Country:US
Practice Address - Phone:763-236-0600
Practice Address - Fax:763-427-9626
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66922207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine