Richard Peter Cervenka
Foot Surgery
3790 117th Ln Nw
Coon Rapids
, Minnesota 55433-2666
Richard Peter Cervenka
Foot Surgery
3790 117th Ln Nw
Coon Rapids
, Minnesota 55433-2666
(763) 421-3337
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- Richard Peter Cervenka
- 3790 117th Ln Nw
- Coon Rapids, MN
- Zip : 55433-2666
- Fax : (763) 421-3337
- Phone : (763) 421-7300
Second Address
- Richard Peter Cervenka
- 3790 117th Ln Nw
- Coon Rapids, MN
- Zip : 55433-2666
- Fax : (763) 421-3337
- Phone : (763) 421-7300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | 304 | MN |
National Provider Identifier
| NPI | 1306832464 |
|---|---|
| Provider Name | Richard Peter Cervenka |
| First Address | Coon Rapids, MN 55433-2666 |
| Second Address | Coon Rapids, MN 55433-2666 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/09/2005 |
| Last Update Date | 10/05/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 042325400 | (05) | MN |
| 2700252 | (02) | MN |
| 34039CE | BC (01) | MN |
| T39450 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.