Provider Demographics
NPI:1053352567
Name:HOJ, KENNETH (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:HOJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1650 BEAM AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1147
Mailing Address - Country:US
Mailing Address - Phone:651-221-9051
Mailing Address - Fax:651-223-5220
Practice Address - Street 1:1650 BEAM AVE STE 200
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1147
Practice Address - Country:US
Practice Address - Phone:651-221-9051
Practice Address - Fax:651-223-5220
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN297562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H400201482Medicare PIN
MNA96246Medicare UPIN