Individual
DR. MANJUNATH MIZAR PAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E 28TH ST STE H2100, MINNEAPOLIS, MN 55407-3723
(612) 863-6900
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
247084
MA
207RC0000X
Cardiovascular Disease Physician
57-020724
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
62017
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110089084A
—
MA
Enumeration date
06/17/2008
Last updated
03/11/2021
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