Individual
KATHLEEN M AYAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 W 78TH ST STE 100, EDINA, MN 55439-2529
(952) 914-8100
(952) 914-8101
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
(925) 914-8101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28484
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
929385000
—
MN
Enumeration date
03/29/2006
Last updated
11/29/2012
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