Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125064769 | IL |
N | 111NI0900X | Internist | 125064769 | IL |
N | 207R00000X | Internist | 62212 | MN |
N | 111NI0900X | Internist | 62212 | MN |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 62212 | MN |
NPI | 1215355284 |
---|---|
Provider Name | Valmiki Rishi Maharaj |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2014 |
Last Update Date | 28/06/2021 |