Provider Demographics
NPI:1801814959
Name:MIDELFORT, HELGA BERIT (MD)
Entity Type:Individual
Prefix:
First Name:HELGA
Middle Name:BERIT
Last Name:MIDELFORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILLSON RD STE 407
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1345
Mailing Address - Country:US
Mailing Address - Phone:952-924-0798
Mailing Address - Fax:
Practice Address - Street 1:5200 WILLSON RD STE 407
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1345
Practice Address - Country:US
Practice Address - Phone:952-924-0798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1078192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN107819OtherUCARE
MN1520336OtherMEDICA
MN1D084MIOtherBCBS
MN524003OtherPREFERRED ONE