Individual
DR. MICHAEL DEAN MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E 28TH ST STE H2100, MINNEAPOLIS, MN 55407-3723
(612) 863-3900
Mailing address
6232 COTEAU TRL, EDEN PRAIRIE, MN 55344-5204
(612) 508-1717
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49193
MN
207RC0000X
Cardiovascular Disease Physician
Primary
49193
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49193
MEDICAL LICENSE
MN
Enumeration date
05/08/2008
Last updated
03/07/2023
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