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Contact Information

PHILIP B IMHOLTE, MD
1601 GOLF COURSE ROAD
GRAND RAPIDS, MN55744
 Phone: 218-326-5000
 Fax: 218-999-1380
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PHILIP B IMHOLTE · (Male)

NPI Number 1760604623
Status Active
Credentials MD
Entity Individual
Enumeration date 05/02/2007
Last updated 10/21/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 49754
  • MN Medicaid 244940000
  • Other 1760604623 MEDICA
  • Other P00438363 RR MEDICARE PTAN
  • MN Other 17P85IM BCBS
Hospital affiliation(s)
  • GRAND ITASCA CLINIC AND HOSPITAL - (Acute Care)
    1601 GOLF COURSE ROAD
    GRAND RAPIDS, MN 55744
  • UNIVERSITY MEDICAL CENTER-MESABI/ MESABA CLINICS - (Acute Care)
    750 EAST 34TH ST
    HIBBING, MN 55746
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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