Healthcare Provider Details

I. General information

NPI: 1043622053
Provider Name (Legal Business Name): ADRIAN ARAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2014
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 CLEARWATER DR STE 220
MINNETONKA MN
55343-9468
US

IV. Provider business mailing address

347 SMITH AVE N STE 404
SAINT PAUL MN
55102-3354
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6624
  • Fax:
Mailing address:
  • Phone: 651-220-6624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number74995
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: