Basic Information
| Provider Information | |||||||||
| NPI: | 1114014578 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNTER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 DELAWARE ST SE | ||||||||
| Address2: | MMC 292 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122736004 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7505 METRO BLVD STE 400 | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554393010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6125732200 | ||||||||
| FaxNumber: | 6125732274 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 06/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | 21762 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
| ID | Type | State | Issuer | Description | 2T406HU | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 1622536 | 01 | MN | MEDICA-CHOICE | OTHER | 16-02032 | 01 | MN | MEDICA-PRIMARY | OTHER | 300072659 | 01 | RR MEDICARE | OTHER | 457373100 | 05 | MN | MEDICAID | HP21393 | 01 | MN | HEALTH PARTNERS | OTHER | 0051340 | 05 | MT | MEDICAID | 124377 | 01 | MN | U CARE | OTHER | 595910 | 01 | ARAZ | OTHER | 080010 | 01 | MN | FAIRVIEW | OTHER | 1010325 | 01 | MN | PREFERRED ONE | OTHER | 1998195 | 05 | IA | MEDICAID |