Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 41948 | MN |
NPI | 1154335990 |
---|---|
Provider Name | Pramod S Kelkar |
First Address | Maple Grove, MN 55369-7076 |
Second Address | Maple Grove, MN 55369-7076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 07/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0200201 | MEDICA (01) | MN |
038588300 | (05) | MN |
128142F031 | UCARE (01) | MN |
1892372 | AMERICAS PPO (01) | MN |
294M9KE | BLUE CROSS AND BLUE SHIEL (01) | MN |
677941040910 | PREFERREDONE (01) | MN |
G91662 | (02) | |
HP40994 | HEALTHPARTNERS (01) | MN |
P00204492 | RAILROAD MEDICARE (01) | MN |