Healthcare Provider Details

I. General information

NPI: 1689747982
Provider Name (Legal Business Name): LYDIA NAJERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MINNESOTA PHYSICIANS 516 DELAWARE ST SE, ROOM 4-100
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE ST SE, MMC 491
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-626-6777
  • Fax:
Mailing address:
  • Phone: 612-626-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number41318
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: