Individual
MR. EDMUND ALEXANDER LARKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Mailing address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9595
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-17200
MEDICA ONAMIA
MN
01
—
01-19647
MEDICA ISLE
MN
01
—
01-19649
MEDICA HILLMAN
MN
05
—
044927000
—
MN
01
—
151472
UCARE
MN
01
—
410785161
TRICARE CHAMPUS
MN
01
—
504T0LA
BLUE CROSS HOSPITAL
MN
01
—
797S0LA
BLUE CROSS CLINIC
MN
01
—
HP32533
HEALTH PARTNERS
MN
01
—
NA9091027020
PREFERRED ONE
MN
Enumeration date
05/26/2006
Last updated
02/03/2010
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