Healthcare Provider Details

I. General information

NPI: 1225150576
Provider Name (Legal Business Name): BARRY DAVID GARFINKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 EXCELSIOR BLVD SUITE #490
MINNEAPOLIS MN
55416-4688
US

IV. Provider business mailing address

3033 EXCELSIOR BLVD SUITE #490
MINNEAPOLIS MN
55416-4688
US

V. Phone/Fax

Practice location:
  • Phone: 612-922-2597
  • Fax: 612-922-1692
Mailing address:
  • Phone: 612-922-2597
  • Fax: 612-922-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number28270
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: