Provider Demographics
NPI:1730281056
Name:PHILANDER, DENNIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:PHILANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5775 WAYZATA BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:612-314-8072
Mailing Address - Fax:612-314-8072
Practice Address - Street 1:5775 WAYZATA BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1222
Practice Address - Country:US
Practice Address - Phone:612-314-8072
Practice Address - Fax:612-314-8072
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2015-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN020096J2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN634272800Medicaid
MN020096JOtherMN STATE LICENCE
MN634272800Medicaid