Individual
DR. KEVIN MICHAEL COONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
(763) 231-9602
Mailing address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5228569-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5228569-1205
LICENSE
UT
Enumeration date
10/14/2010
Last updated
03/19/2018
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