Healthcare Provider Details

I. General information

NPI: 1952394694
Provider Name (Legal Business Name): ASHOK C KEWALRAMANI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1400
US

IV. Provider business mailing address

233 W 1ST ST
WACONIA MN
55387-1302
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-9903
  • Fax: 612-626-2363
Mailing address:
  • Phone: 952-442-9770
  • Fax: 952-442-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number3544
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number02465
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02465
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number62802
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: