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Individual

SOMU SUPPIAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6500 EXCELSIOR BLVD DEPT OF, ST LOUIS PARK, MN 55426
(952) 993-6032
Mailing address
7401 METRO BLVD STE 210, EDINA, MN 55439-3086
(952) 920-4915

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
5104-850
WI
2085R0001X
Radiation Oncology Physician
Primary
63501
MN

Other

Enumeration date
06/14/2013
Last updated
11/28/2023
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