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Individual

PETER KUMASAKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
640 JACKSON ST, MC 11102F, ST PAUL, MN 55101-2502
(651) 254-3456
(651) 254-5216
Mailing address
8100 34TH AVE S, MC21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7172
(952) 883-5395

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36069
WI
207P00000X
Emergency Medicine Physician
Primary
36596
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
995018400
MN
Enumeration date
03/08/2006
Last updated
06/29/2023
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