Individual
RICHARD PETER CERVENKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3790 117TH LN NW, COON RAPIDS, MN 55433-2666
(763) 421-7300
(763) 421-3337
Mailing address
3790 117TH LN NW, COON RAPIDS, MN 55433-2666
(763) 421-7300
(763) 421-3337
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
304
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042325400
—
MN
01
—
34039CE
BC
MN
Enumeration date
09/23/2005
Last updated
05/10/2017
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