Provider Demographics
NPI:1215909494
Name:HOLTEN, PAUL F (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:HOLTEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6845 LEE AVE N
Mailing Address - Street 2:MS21110Q
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1717
Mailing Address - Country:US
Mailing Address - Phone:763-503-4400
Mailing Address - Fax:763-569-0311
Practice Address - Street 1:6845 LEE AVE N
Practice Address - Street 2:MS 31400A HEALTHPARTNERS BROOKLYN CENTER CLINIC
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1717
Practice Address - Country:US
Practice Address - Phone:763-569-4400
Practice Address - Fax:763-569-0311
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN34319207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN842508600Medicaid
MN110005065Medicare ID - Type Unspecified
E42256Medicare UPIN