Individual
KRISHNAKUMAR KUTTAKKATU BALAKRISHNA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 EAST 28TH STREET, INTERNAL MAIL ROUTE 11326, MINNEAPOLIS, MN 55407-3799
(612) 863-1893
(612) 863-3809
Mailing address
800 EAST 28TH STREET, INTERNAL MAIL ROUTE 11326, MINNEAPOLIS, MN 55407-3799
(612) 863-1893
(612) 863-3809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43851
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403133
MEDICA
MN
05
—
110114500
—
MN
01
—
110237285
RR MEDICARE
—
01
—
140753
UCARE
MN
01
—
1542086
AMERICAS PPO
MN
01
—
41084933956001C180
CHAMPUS
MN
01
—
47D66ME
BCBS
MN
01
—
HP33858
HEALTH PARTNERS
MN
01
—
NA2951028011
PREFERRED ONE
MN
Enumeration date
01/24/2006
Last updated
03/11/2021
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