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Individual

SHIVAN KULASINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43532
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0403132
MEDICA #
MN
05
11620
MN
01
142026
UCARE #
MN
01
1517801
AMERICA'S PPO/ARAZ #
MN
01
20796
NDBS #
MN
01
43G20KU
MNBS #
MN
05
619745100
MN
01
DA9031026977
PREFERRED ONE #
MN
01
HP38423
HEALTHPARTNERS #
MN
01
MN10224701
LHS/BANNERHEALTH #
MN
Enumeration date
05/27/2006
Last updated
06/04/2012
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