Provider Demographics
NPI:1811561376
Name:HANES, ERNEST TAIJIN (DO)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:TAIJIN
Last Name:HANES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ERNEST
Other - Middle Name:TAIJIN
Other - Last Name:JARAMILLO-HANES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:420 DELAWARE ST. SE, MMC 295
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-624-6519
Mailing Address - Fax:612-625-7950
Practice Address - Street 1:420 DELAWARE ST. SE, MMC 295
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-624-6519
Practice Address - Fax:612-625-7950
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty