Individual
STEPHEN KENT DU RIVAGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6845 LEE AVE N, MAIL STOP 31400A, BROOKLYN CENTER, MN 55429-1717
(763) 569-0300
(763) 569-0311
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7961
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29549
MN
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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