Individual
RUTH SUMANA POTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5016 KENT AVE, EDINA, MN 55436-2430
(952) 381-7177
Mailing address
5016 KENT AVE, EDINA, MN 55436-2430
(952) 381-7177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51625
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51625
MEDICAL LICENSE
MN
Enumeration date
05/05/2008
Last updated
04/09/2012
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