Individual
BORIS SUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 BROADWAY ST NE STE 120, MINNEAPOLIS, MN 55413-2196
(612) 871-1145
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1145
(612) 870-5812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
49457
MN
2080P0206X
Pediatric Gastroenterology Physician
Primary
49457
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139276
UCARE
MN
Enumeration date
07/24/2007
Last updated
08/22/2022
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