Provider Demographics
NPI:1215086384
Name:HYVA ELAMA, P.A.
Entity type:Organization
Organization Name:HYVA ELAMA, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMANGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-384-7250
Mailing Address - Street 1:7447 EGAN DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-3303
Mailing Address - Country:US
Mailing Address - Phone:612-384-7250
Mailing Address - Fax:952-226-7158
Practice Address - Street 1:7447 EGAN DR STE 201
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-3303
Practice Address - Country:US
Practice Address - Phone:612-384-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN305M4QUOtherBCBS CONTRACTING PROVIDER
MNC03624Medicare ID - Type Unspecified
MNV00269Medicare UPIN