Provider Demographics
NPI:1295756864
Name:GITTER, JAMES PETER (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PETER
Last Name:GITTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2128
Mailing Address - Country:US
Mailing Address - Phone:763-561-5349
Mailing Address - Fax:
Practice Address - Street 1:6601 LYNDALE AVE S
Practice Address - Street 2:SUITE 220
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2477
Practice Address - Country:US
Practice Address - Phone:612-823-8001
Practice Address - Fax:612-823-1010
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45982207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN856484100Medicaid
MN160K3GIOtherBCBSMN
MN2033420OtherAMERICA'S PPO
WI341001600Medicaid
MN960931040240OtherPREFERRED ONE
MNHP39805OtherHEALTHPARTNERS
MN131071C028OtherUCARE
MN3100199OtherMEDICA
MN960931040240OtherPREFERRED ONE
MNHP39805OtherHEALTHPARTNERS
WI341001600Medicaid