1487889705 NPI number — MRUNMAYEE BARVE M.D

Table of content: MRUNMAYEE BARVE M.D (NPI 1487889705)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487889705 NPI number — MRUNMAYEE BARVE M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARVE
Provider First Name:
MRUNMAYEE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487889705
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1020 W BROADWAY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55411-2504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-302-8200
Provider Business Mailing Address Fax Number:
612-302-8275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8100 42ND AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HOPE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55427-1107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-581-5700
Provider Business Practice Location Address Fax Number:
763-581-5701
Provider Enumeration Date:
05/18/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  54896 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)