Provider Demographics
NPI:1720177025
Name:HAMBURGEN, THOMAS C (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:HAMBURGEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7078
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55903-7078
Mailing Address - Country:US
Mailing Address - Phone:507-251-9757
Mailing Address - Fax:507-206-0398
Practice Address - Street 1:2827 OAKVIEW DR NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-7640
Practice Address - Country:US
Practice Address - Phone:507-251-9757
Practice Address - Fax:507-206-0398
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN079D2HAOtherBLUE CROSS BLUESHIELD