MEDICARE: DR. MILIND YASHWANT JUNGHARE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	APPLICATION SUBMITTE	MN
2	207RN0300X	Nephrology Physician	261QM1300X	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50269	OTHER	MN	MINNESOTA MEDICAL LICENSE

General Provider Information

NPI Number	:	1205020294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILIND YASHWANT JUNGHARE MD

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2924
Country	:	US
Telephone Number	:	763-782-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2924
Country	:	US
Telephone Number	:	763-782-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2007
Last Update Date	:	02/10/2014

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