Individual
DR. TAMIKA BRANDON LASEGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(973) 573-3175
Mailing address
5933 SAINT JOHNS AVE, EDINA, MN 55424-1832
(973) 573-3175
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40869
KY
208000000X
Pediatrics Physician
IP871
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
N6449
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100394280
—
KY
Enumeration date
02/21/2007
Last updated
02/07/2019
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