Individual
DR. ROGER AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3955 PARKLAWN AVE, EDINA, MN 55435-5655
(953) 831-4454
Mailing address
4008 GRIMES AVE S, EDINA, MN 55416-5060
(612) 308-2319
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44640
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2426217
—
OH
Enumeration date
06/03/2006
Last updated
03/17/2018
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