Individual
DR. ELIAS BAZAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3833 COON RAPIDS BLVD NW, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Mailing address
3833 COON RAPIDS BLVD NW, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
50602
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501075
MEDICA
MN
01
—
130001380
MEDICARE
MN
01
—
1437276573
AMERICA'S PPO
MN
01
—
1437276573
BCBS
—
05
—
35209300
—
WI
01
—
HP97694
HEALTHPARTNERS
MN
Enumeration date
03/23/2007
Last updated
05/17/2022
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