Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 36878 | MN |
Y | 208600000X | Surgeon | 36878 | MN |
N | 2086S0102X | Surgical Critical Care | 36878 | MN |
N | 2086S0127X | Trauma Surgeon | 36878 | MN |
NPI | 1396772729 |
---|---|
Provider Name | John Cumming |
First Address | Orono, MN 55356-9690 |
Second Address | Minneapolis, MN 55415-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 01/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102821900 | (05) | MN |
F82072 | (02) |