Provider Demographics
NPI:1366884991
Name:BENGTSON, HANS CHRISTIAN (PA-C)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:CHRISTIAN
Last Name:BENGTSON
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4200 DAHLBERG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4840
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5651
Practice Address - Street 1:9630 GROVE CIR N
Practice Address - Street 2:SUITE 200
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-3464
Practice Address - Country:US
Practice Address - Phone:763-520-7870
Practice Address - Fax:763-520-7580
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2016-09-07
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Provider Licenses
StateLicense IDTaxonomies
IA002425363A00000X
MN11573363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant