Individual
ALLEN KEITH WESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
799 REANEY AVE, SAINT PAUL, MN 55106-4412
(651) 232-1700
Mailing address
E2965 BENRUD LN, EAU CLAIRE, WI 54701-8581
(715) 878-9741
(715) 878-4675
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40525
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155517100
—
MN
Enumeration date
05/25/2006
Last updated
05/16/2019
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