Southdale Internal Medicine PA
Internal Medicine in Edina, MN. Organization (NPI-2).
NPI number1346207149
StatusActive
Last updated in NPPESDec 28, 2015
Details
- NPI
- 1346207149
- Entity type
- Organization (NPI-2)
- Legal business name
- Southdale Internal Medicine PA
- Organization subpart
- No
- Enumeration date
- Apr 27, 2006
- Last updated
- Dec 28, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
6545 France Avenue SouthSuite 510
Edina, MN 55435
Phone 952-927-7079 · Fax 952-920-9758
Mailing address
6545 France Avenue SouthSuite 510
Edina, MN 55435
Phone 952-927-7079 · Fax 952-920-9758
Authorized official
Gary L Brunkow
Physician Senior Partner
9529277079
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