Individual
THEMISTOCLES PETER ECONOMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7760 FRANCE AVE S STE 1000, BLOOMINGTON, MN 55435-5870
(952) 746-6767
(952) 746-6768
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5309
(651) 222-6786
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
37341
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384325400
—
MN
Enumeration date
10/03/2006
Last updated
10/07/2020
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