Provider Demographics
NPI:1669617940
Name:HELLRUNG, DANIEL JEROME (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JEROME
Last Name:HELLRUNG
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4050 COON RAPIDS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2522
Mailing Address - Country:US
Mailing Address - Phone:763-236-8109
Mailing Address - Fax:763-236-8185
Practice Address - Street 1:4050 COON RAPIDS BLVD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2522
Practice Address - Country:US
Practice Address - Phone:763-236-8109
Practice Address - Fax:763-236-8185
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN50850207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine