Provider Demographics
NPI:1962555920
Name:BELL, BRIAN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOSEPH
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6500 EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4702
Practice Address - Country:US
Practice Address - Phone:952-993-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN185162085R0202X
MN506052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1962555920OtherMINNESOTA MA
MN1962555920OtherAMERICA'S PPO
MN1962555920OtherUCARE
MNENROLLEDMedicaid
MN1962555920OtherBLUE CROSS BLUE SHIELD
MN96037154238OtherPREFERRED ONE
WI1962555920OtherWISCONSIN MA
MNHP94006OtherHEALTHPARTNERS
MNP00835580OtherRAILROAD MEDICARE
MN1962555920OtherMEDICA
MNP00835580OtherRAILROAD MEDICARE
MN300004718Medicare PIN