Individual
KENNETH GERARD PALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8575
(952) 432-6161
(952) 432-7019
Mailing address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8575
(952) 432-6161
(952) 432-7019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25885
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28263400
—
MN
Enumeration date
06/14/2006
Last updated
09/18/2007
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