Individual
DR. BRUCE IRA IDELKOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 W 66TH ST, SUITE 150, EDINA, MN 55435-2109
(952) 920-7200
(763) 302-4234
Mailing address
3400 W 66TH ST, SUITE 150, EDINA, MN 55435-2109
(952) 920-7200
(763) 302-4234
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22536
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265008
PREFERRED ONE
MN
01
—
0501641
MEDICA
MN
01
—
07620ID
BCBS OF MN
MN
01
—
100288C029
UCARE
MN
01
—
130005771
RAILROAD MEDICARE
MN
01
—
25828
AMERICA'S PPO
MN
05
—
30203900
—
MN
05
—
489092200
—
MN
01
—
HP13585
HEALTHPARTNERS
MN
Enumeration date
05/28/2006
Last updated
12/02/2011
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