Individual
DR. HERODOTOS ELLINAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 273-3000
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 273-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
41755
WI
207L00000X
Anesthesiology Physician
Primary
72674
MN
207LP3000X
Pediatric Anesthesiology Physician
41755
WI
207LP3000X
Pediatric Anesthesiology Physician
72674
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306934179
—
WI
05
—
64320880
—
KY
Enumeration date
10/10/2006
Last updated
02/20/2023
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