Individual
STEPHEN D PENKHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E MAIN ST, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
PO BOX 8674, 123 E MAIN ST, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
22584
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0702739
MEDICA
MN
01
—
115550
UCARE
MN
01
—
160025570
RR MEDICARE
—
01
—
41084933956001C059
CHAMPUS
—
01
—
41497PE
BCBS
MN
05
—
688705800
—
MN
01
—
771902
AMERICAS PPO
MN
05
—
928614
—
IA
01
—
HP25860
HEALTH PARTNERS
MN
01
—
NA2951023851
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
08/11/2011
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