Provider Demographics
NPI:1780689497
Name:DENIER, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:DENIER
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 1:11995 SINGLETREE LN STE 500
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5349
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:11995 SINGLETREE LN STE 500
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-5349
Practice Address - Country:US
Practice Address - Phone:952-595-1301
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1512322085R0202X
MI43014070662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q26008OtherBCBS PROVIDER NUMBER
0Q26008042OtherFED BLACK LUNG PROGRAM
0H26188038OtherFED BLACK LUNG PROGRAM
MI425939310OtherPROCARE
MI0H26188OtherBCBS PROVIDER NUMBER
MI1006439OtherMCLAREN HEALTH
300116200OtherPALMETTO GBA RR MEDICARE
MI123883OtherGREAT LAKES HEALTH
MI4259393Medicaid
MI4259393Medicaid
MI123883OtherGREAT LAKES HEALTH
MI0Q26008042Medicare ID - Type Unspecified
0H26188038OtherFED BLACK LUNG PROGRAM
MI0Q26008OtherBCBS PROVIDER NUMBER