Individual
DR. AJAYDAS THALAPPIL MANIKKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-5000
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-124189
IL
207R00000X
Internal Medicine Physician
Primary
73088
MN
208M00000X
Hospitalist Physician
036-124189
IL
208M00000X
Hospitalist Physician
059829
GA
Other
Enumeration date
05/01/2007
Last updated
04/13/2023
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