Basic Information
| Provider Information | |||||||||
| NPI: | 1275634842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGG | ||||||||
| FirstName: | DANIEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 E 25TH STREET | ||||||||
| Address2: | |||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557462341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183123002 | ||||||||
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| Practice Location | |||||||||
| Address1: | 750 E 34TH ST | ||||||||
| Address2: | |||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557462341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182624881 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 10/18/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 34144 | MN | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | MN34144 | MN | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 33435OG | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 2080750 | 01 | MN | MEDICA | OTHER | 1275634842 | 01 | MN | NPI | OTHER | 050012530 | 01 | MN | RAILROAD MEDICARE | OTHER | 114066 | 01 | MN | UCARE | OTHER | 002503800 | 05 | MN | MEDICAID |