Individual
AMANDA M TERMUHLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-7422
Mailing address
420 DELAWARE ST SE, MMC 484, MINNEAPOLIS, MN 55455-0341
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
64033
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107712000
MEDICAID
WV
05
—
0804928
—
OH
01
—
64869704
MEDICAID
KY
Enumeration date
10/07/2005
Last updated
07/03/2018
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