Provider Demographics
NPI:1851332399
Name:TUBMAN, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:TUBMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2232
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2232
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN261042085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0247015OtherPREFERRED ONE
MN100721OtherUCARE
ND23691OtherBLUE CROSS BLUE SHIELD
MN299G2TUOtherBLUE CROSS
MN290367900Medicaid
MN300085304OtherRAILROAD MEDICARE MN
MN23023OtherAMERICA'S PPO
WI31569000Medicaid
MNHP14582OtherHEALTHPARTNERS
IA1505370Medicaid
MN18010TUOtherBLUE CROSS
ND23691OtherBLUE CROSS BLUE SHIELD
MN300085304OtherRAILROAD MEDICARE MN
MNE34323Medicare UPIN
MN300000093Medicare PIN