Provider Demographics
NPI:1841485596
Name:ODLAND, HELEN PALUMBO (MD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:PALUMBO
Last Name:ODLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:433 SOUTH OWASSO BLVD WEST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2121
Mailing Address - Country:US
Mailing Address - Phone:651-482-9397
Mailing Address - Fax:
Practice Address - Street 1:2431 HENNEPIN AVE SO
Practice Address - Street 2:UPTOWN COMMUNITY CLINIC NEIGHBORHOOD INVOLVEMENT PROGRA
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405
Practice Address - Country:US
Practice Address - Phone:612-374-4089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN29241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A93622Medicare UPIN