Individual
EITAN MEDINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 CENTRA CARE CIR #1600, CENTRA CARE CLINIC HEALTH PLAZA / RADIATION ONCOLOGY, ST CLOUD, MN 56303-5000
(320) 229-4901
(320) 229-5160
Mailing address
1900 CENTRA CARE CIR #1600, CENTRA CARE CLINIC HEALTH PLAZA / RADIATION ONCOLOGY, ST CLOUD, MN 56303-5000
(320) 229-4901
(320) 229-5160
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
21866
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1027482
PREFERRED ONE
—
01
—
127789
U CARE
—
01
—
2400101
MEDICA HEALTH PLANS
—
05
—
252563100
—
MN
01
—
315JOME
BLUE CROSS BLUE SHIELD
—
01
—
512RIME
BLUE CROSS BLUE SHIELD
—
01
—
978660
ARAZ GROUP AMERICAS PPO
—
01
—
COMP
FIRST HEALTH PLAN
—
01
—
HP33037
HEALTH PARTNERS
—
Enumeration date
11/02/2005
Last updated
08/10/2011
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