Daniel E Noonan, MD

Individual provider Active NPI Family Medicine Physician · Osseo, MN

NPI 1790711984 · NPPES record last updated Oct 20, 2020

Key facts

NPI
1790711984
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
27706 (MN)
Practice address
50 Central Ave
Osseo, MN 55369-1241
Phone
(763) 420-1900
Fax
(763) 420-1901
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27706MNMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27706 MN Yes

Addresses

Primary practice location

50 Central Ave
Osseo, MN 55369-1241

Mailing address

50 Central Ave
Osseo, MN 55369-1241
Phone (763) 587-7900

Other identifiers

IdentifierTypeStateIssuer
128275100MedicaidMN

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address daniel.noonan@nor.eclinicaldirectplus.com

Other providers in Osseo, MN

All providers in Osseo, MN · Family Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.