Individual
DR. ELENA L POLUKHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
3015 UTAH AVE S, SUITE 200, SAINT LOUIS PARK, MN 55426-3671
(952) 933-1121
(952) 945-9536
Mailing address
3006 FRANK ST, MAPLEWOOD, MN 55109-5501
(651) 699-0633
(651) 797-3592
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
45600
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630074000
—
MN
Enumeration date
06/04/2006
Last updated
07/08/2007
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