Individual
SHONALIE LEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 E NICOLLET BLVD, STE 200, BURNSVILLE, MN 55337-6732
(952) 898-5900
(952) 278-6947
Mailing address
3955 PARKLAWN AVE, STE 120, EDINA, MN 55435-5655
(952) 831-1944
(952) 278-6947
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
49177
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1213786
MEDICA
MN
01
—
FP9021048582
PREFERRED ONE
MN
Enumeration date
01/30/2007
Last updated
07/08/2007
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