DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

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Active Sole Proprietor

Family Medicine · EXCELSIOR, MN

Registration Details

NPI Number
1306223532
Provider Type
Individual
Gender
Male
NPI Issued
Apr 27, 2015 (11.048474410289 yrs)
Last Updated
Nov 17, 2020
License
60888 (MN)
Sole Proprietor
Yes

Practice Information

Address
19685 HIGHWAY 7
EXCELSIOR, MN, 553317516
Browse MN providers · Browse ZIP 55331
Phone
9529934350
Primary Specialty
Family Medicine
207Q00000X

Other Family Medicine Providers in EXCELSIOR, MN

Name Credential NPI
MICHAEL T SCHULENBERG MD 1962402834
SWARNA ERRAMREDDI LATHA M.D 1912013954
ELIZABETH LYNN KENNEDY DO 1215007414
MS. BRIANA MARIE RUEDA DO 1154505287
DR. HILARY M HAMMELL D.O. 1386963296
DR. LUCY KURTZ EIKEVIK 1215349246
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.