Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 36869 | MN |
N | 2080P0204X | Pediatric Emergency Doctor | 36869 | MN |
NPI | 1003850173 |
---|---|
Provider Name | Dr. Pablo Ureta Avendano |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052054 | (05) | MT |
0544627 | (05) | IA |
1016106 | PREFERRED ONE (01) | MN |
170869 | UCARE (01) | MN |
39-01535 | MEDICA CHOICE (01) | MN |
50G12AV | BCBS (01) | MN |
772066 | ARAZ (01) | MN |
F73454 | (02) | MN |
HP26583 | HEALTHPARTNERS (01) | MN |