Basic Information
| Provider Information | |||||||||
| NPI: | 1770510281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CURRENT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UFP PHALEN VILLAGE CLINIC | ||||||||
| Address2: | 1414 MARYLAND AVENUE EAST | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517723461 | ||||||||
| FaxNumber: | 6517722605 | ||||||||
| Practice Location | |||||||||
| Address1: | UFP PHALEN VILLAGE CLINIC | ||||||||
| Address2: | 1414 MARYLAND AVENUE EAST | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517723461 | ||||||||
| FaxNumber: | 6517722605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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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 | 207Q00000X | 23322 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01-22145 | 01 | MN | MEDICA CHOICE & PRIMARY | OTHER | 0D051CU | 01 | MN | BCBS | OTHER | 1000668 | 01 | MN | PREFERRED ONE | OTHER | 100522 | 01 | MN | UCARE | OTHER | 768075 | 01 | MN | ARAZ | OTHER | HP16052 | 01 | MN | HEALTHPARTNERS | OTHER |