Provider Demographics
NPI:1942224431
Name:HERGOTT, PATRICK F (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:F
Last Name:HERGOTT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3050 CENTRE POINTE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:651-639-9150
Mailing Address - Fax:651-639-9153
Practice Address - Street 1:775 PRAIRIE CENTER DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344
Practice Address - Country:US
Practice Address - Phone:952-253-6400
Practice Address - Fax:952-253-6401
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN19173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D48643Medicare UPIN