Individual
KEITH BAKKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 BEAM AVE, MAPLEWOOD, MN 55109-1162
(651) 779-2500
(651) 770-8834
Mailing address
1021 BANDANA BLVD E, SUITE 200, SAINT PAUL, MN 55108-5113
(651) 642-2700
(651) 642-9441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23469
MN
Other
Enumeration date
07/04/2006
Last updated
07/08/2007
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