Individual
RICHARD A KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
424 HARVARD STREET SE, MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
420 DELAWARE ST SE, MMC 485 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18601
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051753
—
MT
01
—
04-00123
MEDICA-PRIMARY
MN
01
—
04-24506
MEDICA-CHOICE
MN
01
—
089086
FAIRVIEW
MN
05
—
0974022
—
IA
01
—
1010343
PREFERRED ONE
MN
01
—
101417
U CARE
MN
05
—
217578900
—
MN
01
—
2T154KI
BCBS
MN
Enumeration date
10/13/2006
Last updated
07/09/2007
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