Individual
DR. WAYNE R KANIEWSKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7905 GOLDEN TRIANGLE DR, STE 190, EDEN PRAIRIE, MN 55344-7220
(952) 993-8615
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34219
MN
Other
Enumeration date
12/07/2005
Last updated
07/08/2007
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