DR. GLEN JOSEPH BOOTH (NPI# 1083740393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083740393 |
Entity Type | Individual |
Full Name | DR. GLEN JOSEPH BOOTH |
Credential | M.D. |
Practice Address |
1089 25th Ave Se Minneapolis MN 55414-2637 |
Practice Telephone | 6123790212 |
Mailing Telephone | 6123790212 |
Enumeration Date | 2007-02-23 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | B29991 | MN | Allopathic & Osteopathic Physicians |
Street Address |
1089 25TH AVE SE |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55414-2637 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
1346888732 | Danielle Lee Ann Vogler-bos | Naturopath | 575 Se 9th St, Suite #52, Minneapolis, MN 55414 | 2019-12-16 |
1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
1346806585 | Kristen Bastug | Student in an Organized Health Care Education/Training Program | General Pediatrics and Adolescent Health, 1932k, 1717 Delaware Street Southeast, Suite 353, Minneapolis, MN 55414 | 2019-05-14 |
1053881698 | Lauren Michelle Scholder | Psychologist | 401 Main St Se Apt 7009, Minneapolis, MN 55414 | 2018-11-27 |
1427530666 | Kelli Howard | Psychologist | 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2018-09-04 |
1306370218 | Jiexiong Yang | Student in an Organized Health Care Education/Training Program | 814 Essex St Se, Minneapolis, MN 55414 | 2017-04-18 |
1598297699 | Patrick Curran | Student in an Organized Health Care Education/Training Program | 628 University Ave Se, Apt. 112, Minneapolis, MN 55414 | 2017-03-29 |
1679923957 | Jillian Theresa Tholen | Dietitian, Registered | 411 E Hennepin Ave, Minneapolis, MN 55414 | 2016-06-16 |
1073960290 | First Language Interpreter & Translation Services LLC | Interpreter | 2828 University Ave Se Suite 150, Minneapolis, MN 55414 | 2016-05-17 |
Find all providers in zip 55414 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447857230 | Minneapolis Integrative Medicine Center, LLC | General Practice | 575 9th St Se Ste 52, Minneapolis, MN 55414-1399 | 2020-10-05 |
1689930554 | Linda Gail Olson | General Practice | 17935 24th Ave N, Minneapolis, MN 55447 | 2012-04-05 |
1487947248 | Ken Rosenblum | General Practice | 1418 Mount Curve Ave, Minneapolis, MN 55403-1010 | 2011-05-25 |
1235469594 | Andrej John Szabad | General Practice | 1615 E River Ter, Minneapolis, MN 55414-3676 | 2010-01-10 |
1861725335 | Chs Tennessee Medical, PC | General Practice | 380 Ameriprise Financial Ctr, Minneapolis, MN 55474-0003 | 2009-09-15 |
1477721157 | Akbar Sajady | General Practice | 4400 Oliver Avenue North, Minneapolis, MN 55412-1123 | 2008-02-14 |
1083734826 | Kenneth Reed Mcmillan | General Practice | 2020 Bloomington Ave, Minneapolis, MN 55404-3073 | 2007-03-29 |
1811934763 | Neighborhood Healthsource | General Practice | 2301 Central Ave Ne, Minneapolis, MN 55418 | 2006-06-01 |
1871101238 | Fairview Express Care | General Practice | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-07-21 |
1811530256 | Sme Minnesota P.C. | General Practice | 100 N 6th St, Minneapolis, MN 55403-1505 | 2019-10-17 |
Find all providers in MINNEAPOLIS |
City | MINNEAPOLIS |
Zip Code | 55414 |
Please comment or provide details below to improve the information on DR. GLEN JOSEPH BOOTH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.