Organization
DIAMOND LAKE CLINIC, P.C.
Active
Organization
DIAMOND LAKE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUKWUEMEKA ALEXANDER ANYAKE MD/MBBS (PHYSICIAN)
(612) 806-3011
Entity
Organization
Contact information
Practice address
5939 PORTLAND AVE, MINNEAPOLIS, MN 55417-3127
(612) 806-3011
Mailing address
5939 PORTLAND AVE, MINNEAPOLIS, MN 55417-3127
(612) 806-3011
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
52657
MN
261QM0850X
Adult Mental Health Clinic/Center
53530
MN
261QP2300X
Primary Care Clinic/Center
52657
MN
305S00000X
Point of Service
52657
MN
Other
Enumeration date
05/27/2015
Last updated
04/01/2025
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