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Organization
UNIVERSITY OF MINNESOTA
Active
Organization
UNIVERSITY OF MINNESOTA
Active
Parent organization
UNIVERSITY OF MINNESOTA (NEUROLOGY)
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF MINNESOTA (NEUROLOGY)
Authorized official
DR. JERROLD LEE VITEK M.D. (CHAIR, NEUROLOGY DEPT.)
(612) 625-5993
Entity
Organization
Contact information
Practice address
515 DELAWARE ST. SE, MOOS TOWER, ROOM 13-129, MINNEAPOLIS, MN 55455
(612) 626-7403
(612) 301-1455
Mailing address
420 DELAWARE ST. SE, MMC295 MAYO, MINNEAPOLIS, MN 55455
(612) 626-4703
(612) 301-1455
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
NULL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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