Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 53825 | MN |
N | 111NI0900X | Internist | 53825 | MN |
Y | 207RI0200X | Infectious Disease | 53825 | MN |
NPI | 1083814628 |
---|---|
Provider Name | Edwin Pereira |
First Address | Minneapolis, MN 55455-0363 |
Second Address | Minneapolis, MN 55455-0363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 11/03/2021 |