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Individual

PRAVEENA M KANTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6545 FRANCE AVE S, SUITE 150, EDINA, MN 55435-2131
(952) 848-5600
(952) 848-5573
Mailing address
6545 FRANCE AVE S, SUITE 150, EDINA, MN 55435-2131
(952) 848-5600
(952) 848-5573

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36578
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
337025900
MN
Enumeration date
06/22/2005
Last updated
03/22/2012
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