Individual
IAN MCKELVEY MOORHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 OSBORNE RD NE, UNITY HOSPITAL, FRIDLEY, MN 55432
(763) 236-4144
(763) 236-4900
Mailing address
5435 FELTL RD, MINNETONKA, MN 55343-7983
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27626
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024888600
—
MN
01
—
27626
MN MEDICAL LICENSE
MN
Enumeration date
03/07/2006
Last updated
03/31/2010
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