Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 33037 | MN |
NPI | 1013995356 |
---|---|
Provider Name | Dr. Winston P Cavert |
First Address | St Louis Park, MN 55426-1728 |
Second Address | Minneapolis, MN 55455-0341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 01/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E22933 | (02) | MN |