Provider Demographics
NPI:1255438560
Name:ROELOFS, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ROELOFS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-273-6004
Mailing Address - Fax:612-273-8459
Practice Address - Street 1:500 HARVARD ST SE
Practice Address - Street 2:UNIT J2-300
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0363
Practice Address - Country:US
Practice Address - Phone:612-273-6004
Practice Address - Fax:612-273-8459
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN213462085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP40527OtherHEALTH PARTNERS
MN1010254OtherPREFERRED ONE
MN337675OtherFAIRVIEW
FM1723079OtherARAZ
MN16-02032OtherMEDICA PRIMARY
MN16-02747OtherMEDICA CHOICE
MN107102OtherUCARE