Organization
MAPLE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANAN S SHUKLA M.D. (CEO)
(952) 843-4333
Entity
Organization
Contact information
Practice address
7261 OHMS LN, EDINA, MN 55439-2148
(952) 843-4333
(952) 843-4301
Mailing address
9825 HOSPITAL DRIVE, #105, MAPLE GROVE, MN 55369
(763) 420-0580
(763) 420-0581
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43570
MN
Other
Enumeration date
04/26/2007
Last updated
11/09/2007
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