Provider Demographics
NPI:1598729550
Name:DONOHUE, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:DONOHUE
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:426 10TH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2341
Practice Address - Country:US
Practice Address - Phone:507-376-5665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21979207X00000X
MN26094207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN001011100Medicaid
MN200010036OtherRAILROAD MEDICARE
IA0226639Medicaid
IA02699Medicare PIN
MN200010036OtherRAILROAD MEDICARE
IAA02659Medicare UPIN
IA0288350002Medicare NSC
IA200010036Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MN001011100Medicaid
MN0288350004Medicare NSC
IA0288350001Medicare NSC
MN0288350002Medicare NSC
MN0288350006Medicare NSC
IA0288350006Medicare NSC
IA0288350004Medicare NSC