Provider Demographics
NPI:1679899892
Name:SLOTS, HENRIK (MD)
Entity type:Individual
Prefix:DR
First Name:HENRIK
Middle Name:
Last Name:SLOTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3609
Mailing Address - Country:US
Mailing Address - Phone:651-471-5800
Mailing Address - Fax:
Practice Address - Street 1:9900 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3609
Practice Address - Country:US
Practice Address - Phone:651-471-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14785207Q00000X
MN72986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1679899892Medicaid
12515987OtherCAQH