Individual
DR. ALLAN PHILLIP INGENITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3833 COON RAPIDS BLVD NW, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Mailing address
3833 COON RAPIDS BLVD NW, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
29584
MN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
29584
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265011
PREFERRED ONE
MN
01
—
0509674
MEDICA
MN
01
—
07691IN
BCBS OF MN
MN
01
—
100289C029
UCARE
MN
01
—
130005768
RAILROAD MEDICARE
MN
05
—
162078900
—
MN
01
—
22676
AMERICA'S PPO
MN
01
—
30709400
WI MEDICAID
WI
01
—
HP13588
HEALTHPARTNERS
MN
Enumeration date
06/08/2006
Last updated
03/19/2019
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