Basic Information
| Provider Information | |||||||||
| NPI: | 1689614794 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOCKMAN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 PARK AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554151623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128733000 | ||||||||
| FaxNumber: | 6235236581 | ||||||||
| Practice Location | |||||||||
| Address1: | 12805 HWY 55 STE 304 | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554413826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529991908 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 03/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 25248 | AZ | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 52487 | MN | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081P0301X | 52487 | MN | Y |
No ID Information.