Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 48227 | MN |
Y | 2080P0205X | Pediatric Endocrinologist | 48227 | MN |
NPI | 1487615969 |
---|---|
Provider Name | Constantinos Voulgaropoulos |
First Address | Roseville, MN 55113 |
Second Address | St Paul, MN 55102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 03/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
822916300 | (05) | MN |