Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 32878 | MN |
N | 2084N0402X | Child Neurologist | 32878 | MN |
NPI | 1336145051 |
---|---|
Provider Name | Steven T Janousek |
First Address | Minneapolis, MN 55407-1320 |
Second Address | Minneapolis, MN 55407-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 07/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130000928 | (02) | MN |
485797600 | (05) | MN |
D82038 | (02) |