Southdale Internal Medicine PA

NPI #1346207149 in Edina, Minnesota

Provider Information

NPI Number: 1346207149
Entity Type: Organization
Organization Name: Southdale Internal Medicine PA
Primary Specialty: Internal Medicine
Enumeration Date: Apr 27, 2006
Last Updated: Dec 28, 2015

Practice Location

Address: 6545 FRANCE AVENUE SOUTH
Address 2: SUITE 510
City: Edina
State: Minnesota
ZIP Code: 55435
Phone: (952) 927-7079

Authorized Official

Name: DR. GARY L BRUNKOW
Title: PHYSICIAN SENIOR PARTNER
Phone: (952) 927-7079

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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