Individual
EVAN KENDAHL MOSER-BLEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3305 CENTRAL PARK VILLAGE DR, EAGAN, MN 55121-7707
(651) 406-8860
Mailing address
3305 CENTRAL PARK VILLAGE DR, EAGAN, MN 55121-7707
(651) 406-8860
(651) 406-8870
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58130
MN
208000000X
Pediatrics Physician
58130
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2012
Last updated
09/27/2019
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