Provider Demographics
NPI:1720010853
Name:CARTWRIGHT, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:LAB MEDICINE AND PATHOLOGY MMC 609 MAYO BLDG
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-2298
Mailing Address - Country:US
Mailing Address - Phone:612-626-0622
Mailing Address - Fax:651-264-4646
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MMC 609 MAYO BLDG
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-2298
Practice Address - Country:US
Practice Address - Phone:612-626-0622
Practice Address - Fax:651-264-4646
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45194207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN191813300Medicaid
MN099565700Medicaid
MN590638500Medicaid
690610930Medicare ID - Type UnspecifiedGROUP CRP
220000899Medicare ID - Type UnspecifiedINDIVIDUAL UUP
MN099565700Medicaid
C01224Medicare ID - Type UnspecifiedGROUP UUP