Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 41703 | MN |
NPI | 1295819498 |
---|---|
Provider Name | Anna Petryk |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0051935 | (05) | MT |
1020148 | PREFERRED ONE (01) | MN |
10387 | (05) | ND |
123733 | UCARE (01) | MN |
20G50PE | BLUE CROSS BLUE SHIELD (01) | MN |
32593900 | (05) | WI |
33-00009 | MEDICA PRIMARY (01) | MN |
33-07044 | MEDICA CHOICE (01) | MN |
731022600 | (05) | MN |
7777470 | (05) | SD |
844859 | ARAZ (01) | MN |
H04720 | (02) | |
HP28931 | HEALTH PARTNERS (01) | MN |