Provider Demographics
NPI:1730130113
Name:POPE, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:POPE
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 1:501 N STATE ST
Mailing Address - Street 2:WASECA MEDICAL CENTER - MAYO HEALTH SYSTEM
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093-2811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 N STATE ST
Practice Address - Street 2:WASECA MEDICAL CENTER - MAYO HEALTH SYSTEM
Practice Address - City:WASECA
Practice Address - State:MN
Practice Address - Zip Code:56093-2811
Practice Address - Country:US
Practice Address - Phone:507-835-1210
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN39-09161OtherMEDICA
MN115157OtherMNCARE-U
MN1M775POOtherBCBS
MN41P59POOtherBCBS
MNNA9501022809OtherPREFERREDONE
MN0103183OtherMEDICA
MNHP20794OtherHEALTHPARTNERS
MN0103183OtherMEDICA
MNCN7693Medicare ID - Type UnspecifiedMEDICARE RAILROAD