Individual
DR. KEVIN M. TAKAKUWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
45 10TH ST W, SAINT PAUL, MN 55102-1062
(651) 232-3000
(651) 232-1187
Mailing address
615 CHESTNUT ST, 14TH FLOOR, PHILADELPHIA, PA 19106-4404
(215) 955-1175
(215) 955-2420
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
61761
MN
207P00000X
Emergency Medicine Physician
Primary
MD421356
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062499
—
NJ
05
—
101228458
—
PA
Enumeration date
07/13/2006
Last updated
07/21/2022
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