Individual
DR. JOHN RAYMOND FENYK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 DELAWARE ST SE, MMC 98, MINNEAPOLIS, MN 55455-0356
(612) 625-5656
(612) 624-6678
Mailing address
516 DELAWARE ST SE, MMC 98, MINNEAPOLIS, MN 55455-0356
(612) 625-5656
(612) 624-6678
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
23247
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00003
MEDICA PRIMARY
MN
01
—
03-03331
MEDICA CHOICE
MN
01
—
0716001
PREFERRED ONE
MN
05
—
305893000
—
MN
01
—
411436271001
CHAMPUS
MN
01
—
HP13270
HEALTHPARTNERS
MN
01
—
OG471FE
BCBS
MN
Enumeration date
07/06/2006
Last updated
06/04/2008
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