Individual
KEVIN HERBERT BOEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-1000
Mailing address
420 DELAWARE ST SE, DIAGNOSTIC RADIOLOGY, MMC 292, MINNEAPOLIS, MN 55455-0341
(651) 592-3931
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
59081
MN
2085R0202X
Diagnostic Radiology Physician
Primary
59081
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2013
Last updated
06/03/2019
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