Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25914 | MN |
Y | 208600000X | Surgeon | 25914 | MN |
NPI | 1003960006 |
---|---|
Provider Name | Dr. Allen Lester Vanbeek |
First Address | Edina, MN 55435-4534 |
Second Address | Edina, MN 55435-4534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 01/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251502400 | (05) | MN |
B58662 | (02) | MN |