Individual
DR. KOZHUVATTASSERI PADMANABHA MADHUSOODANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE CLINIC 3B, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-3600
Mailing address
420 DELAWARE ST SE MMC 508, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-3600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
42532
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0534461
—
IA
01
—
1024914
PREFERREDONE
—
05
—
10387
—
ND
01
—
1053385
ARAZ
—
01
—
127916
UCARE
—
05
—
128412600
—
MN
01
—
25-00021
MEDICA PRIMARY
—
01
—
25-00413
MEDICA CHOICE
—
05
—
34017700
—
WI
05
—
7777470
—
SD
01
—
78R23MA
BLUE CROSS BLUE SHIELD
MN
01
—
HP31284
HEALTHPARTNERS
—
01
—
M011
TRIWEST/TRICARE
—
Enumeration date
10/20/2006
Last updated
02/15/2013
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