Organization
SOUTHDALE INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L BRUNKOW (PHYSICIAN SENIOR PARTNER)
(952) 927-7079
Entity
Organization
Contact information
Practice address
6545 FRANCE AVENUE SOUTH, SUITE 510, EDINA, MN 55435
(952) 927-7079
(952) 920-9758
Mailing address
6545 FRANCE AVENUE SOUTH, SUITE 510, EDINA, MN 55435
(952) 927-7079
(952) 920-9758
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/27/2006
Last updated
12/28/2015
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