Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 49521 | MN |
Y | 111NI0900X | Internist | 49521 | MN |
N | 207RA0401X | Internist - Addiction Medicine | 49521 | MN |
NPI | 1518169713 |
---|---|
Provider Name | Dr. Ashwin Vinod George |
First Address | Burnsville, MN 55337-1269 |
Second Address | Burnsville, MN 55337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 15/08/2019 |