Provider Demographics
NPI:1689753246
Name:POLLMANN, BRIAN R (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:R
Last Name:POLLMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CENTURY AVE SE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3108
Mailing Address - Country:US
Mailing Address - Phone:320-587-2020
Mailing Address - Fax:320-484-4686
Practice Address - Street 1:3 CENTURY AVE SE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3108
Practice Address - Country:US
Practice Address - Phone:320-587-2020
Practice Address - Fax:320-234-3295
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN44595207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN317471900Medicaid
MN317471900Medicaid