Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 13347 | MN |
N | 1223G0001X | General Practice | 10360 | CO |
N | 213EG0000X | General Practice | 10360 | CO |
NPI | 1275838187 |
---|---|
Provider Name | Brian J Kajewski |
First Address | Willmar, MN 56201-2276 |
Second Address | Willmar, MN 56201-2276 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2011 |
Last Update Date | 24/02/2017 |