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Individual

DR. SHANE D KIRKEGAARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-2000
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
77259
MN
207R00000X
Internal Medicine Physician
DO-05856
IA

Other

Enumeration date
03/29/2018
Last updated
11/11/2024
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