Provider Demographics
NPI:1013977693
Name:RICHARDS, HALLIE N (MD)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:N
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:MR 10809
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-0043
Mailing Address - Country:US
Mailing Address - Phone:612-262-4813
Mailing Address - Fax:612-262-4194
Practice Address - Street 1:2800 CHICAGO AVE
Practice Address - Street 2:250
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1318
Practice Address - Country:US
Practice Address - Phone:612-863-4096
Practice Address - Fax:612-863-2132
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN27190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D81675Medicare UPIN