Provider Demographics
NPI:1538694245
Name:HAPAK, SOPHIE MARIE
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:MARIE
Last Name:HAPAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 EUSTIS ST STE 150
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-0019
Mailing Address - Country:US
Mailing Address - Phone:612-728-2455
Mailing Address - Fax:612-728-2458
Practice Address - Street 1:767 EUSTIS ST STE 150
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-0019
Practice Address - Country:US
Practice Address - Phone:612-728-2455
Practice Address - Fax:612-728-2458
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66077207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty