Individual
MR. EDMUND ALEXANDER LARKA
Active
Individual
MR. EDMUND ALEXANDER LARKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
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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