Eden Prairie Clinic, PA
NPI #1437459211 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1437459211
- Entity Type
- Organization
- Organization Name
- Eden Prairie Clinic, PA
- Primary Specialty
- Family Medicine
- Enumeration Date
- Oct 27, 2010
- Last Updated
- Oct 28, 2010
Practice Location
- Address
- 9358 ENSIGN AVE S
- Address 2
- SUITE C
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55438-1472
- Phone
- (952) 944-6989
Authorized Official
- Name
- RADHA KRISHNA KUMAR, M.D.
- Title
- OWNER
- Phone
- (952) 944-6989
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adolescent Medicine — Adolescent Medicine |
| Family Medicine - Adult Medicine — Adult Medicine |
| Family Medicine - Geriatric Medicine — Geriatric Medicine |
| Family Medicine |
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