Individual
DR. KEVIN TIMOTHY WAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10562 FRANCE AVE S, BLOOMINGTON, MN 55431-3538
(952) 942-9303
(952) 252-0603
Mailing address
5916 DEWEY HILL RD, EDINA, MN 55439-1724
(952) 942-9303
(952) 944-3917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024526
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024526
MINNESOTA MEDICAL LICENSE
MN
Enumeration date
11/04/2006
Last updated
03/07/2023
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