Provider Demographics
NPI:1932190089
Name:LINDGREN, DAVID R (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:LINDGREN
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 1:1900 CENTRACARE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-654-3630
Mailing Address - Fax:320-654-3657
Practice Address - Street 1:1900 CENTRACARE CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-654-3630
Practice Address - Fax:320-654-3657
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27161207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0702715OtherMEDICA HEALTH PLANS
763001OtherARAZ GROUP AMERICAS PPO
HP25475OtherHEALTH PARTNERS
127007900OtherMEDICAL ASSISTANCE
50A48L1OtherBLUE CROSS BLUE SHIELD
110419OtherUCARE
2114018OtherFIRST HEALTH PLAN
990001OtherPREFERRED ONE
HP25475OtherHEALTH PARTNERS
50A48L1OtherBLUE CROSS BLUE SHIELD
160037447Medicare ID - Type UnspecifiedRR MEDICARE