Provider Demographics
NPI:1578770939
Name:HOPPE, SIGURD M
Entity Type:Individual
Prefix:DR
First Name:SIGURD
Middle Name:M
Last Name:HOPPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 MAIN ST SE
Mailing Address - Street 2:402
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2124
Mailing Address - Country:US
Mailing Address - Phone:612-331-6777
Mailing Address - Fax:612-379-2820
Practice Address - Street 1:219 MAIN ST SE
Practice Address - Street 2:402
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2124
Practice Address - Country:US
Practice Address - Phone:612-331-6777
Practice Address - Fax:612-379-2820
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1401103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6880001326Medicare ID - Type Unspecified