Individual
KIRAN K LASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11850 BLACKFOOT ST NW, SUITE 100, COON RAPIDS, MN 55433-2578
(763) 712-2100
(763) 712-2190
Mailing address
11850 BLACKFOOT ST NW, SUITE 100, COON RAPIDS, MN 55433-2578
(763) 712-2100
(763) 712-2190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23407
NE
207RH0000X
Hematology (Internal Medicine) Physician
53612
MN
207RX0202X
Medical Oncology Physician
Primary
53612
MN
Other
Enumeration date
10/13/2006
Last updated
04/20/2016
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