Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 45945 | MN |
NPI | 1063449957 |
---|---|
Provider Name | Dr. Mimi Cho |
First Address | Edina, MN 55435-2532 |
Second Address | Edina, MN 55435-2532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03-00010 | MEDICA PRIMARY (01) | MN |
03-00339 | MEDICA CHOICE (01) | MN |
1041066 | PREFERRED ONE (01) | MN |
HP42082 | HEALTHPARTNERS (01) | MN |
I05028 | (02) | MN |