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Individual

GURUMURTHY HIREMATH MALLIKARJUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2450 RIVERSIDE AVE, RIVERSIDE EAST BUILDING, #MB552, MINNEAPOLIS, MN 55454-1450
(612) 626-2755
Mailing address
2450 RIVERSIDE AVE, RIVERSIDE EAST BUILDING, #MB552, MINNEAPOLIS, MN 55454-1450
(612) 626-2755

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301092195
MI
208000000X
Pediatrics Physician
Primary
A115159
CA
2080P0202X
Pediatric Cardiology Physician
58949
MN

Other

Enumeration date
08/17/2008
Last updated
06/26/2015
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