Healthcare Provider Details
I. General information
NPI: 1235572306
Provider Name (Legal Business Name): ANDREW JAMES REDMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2013
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 CHICAGO AVE
MINNEAPOLIS MN
55404-4518
US
IV. Provider business mailing address
690 CEDAR VIEW CT
SAINT PAUL MN
55126-1942
US
V. Phone/Fax
- Phone: 952-992-5623
- Fax: 952-992-6917
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 57.022827 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 67048 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YP0228X |
| Taxonomy | Pediatric Otolaryngology Physician |
| License Number | 3129 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: