Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 49124 | MN |
N | 207RP1001X | Pulmonary Disease | 49124 | MN |
NPI | 1063618023 |
---|---|
Provider Name | Mr. Bradley Daniel Chmielewski |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Minneapolis, MN 55407-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 11/03/2021 |