Healthcare Provider Details

I. General information

NPI: 1679765762
Provider Name (Legal Business Name): DIONYSIA KALOGEROPOULOU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TENIA KALOGEROPOULOU MD

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PHALEN BLVD
SAINT PAUL MN
55130-5302
US

IV. Provider business mailing address

8170 33RD AVE S MS 21110Q
BLOOMINGTON MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-7870
  • Fax: 651-254-7876
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number51729
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: