Individual
DR. SAMITH THOMAS KOCHUPARAMBIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 E 26TH ST, SUITE 100, MINNEAPOLIS, MN 55404-4526
(612) 884-6300
(612) 884-6363
Mailing address
910 E 26TH ST, SUITE 100, MINNEAPOLIS, MN 55404-4526
(612) 884-6300
(612) 884-6363
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003640
GA
207RH0003X
Hematology & Oncology Physician
106191
MN
207RH0003X
Hematology & Oncology Physician
Primary
55683
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
WI
Enumeration date
07/15/2009
Last updated
06/09/2015
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