Healthcare Provider Details

I. General information

NPI: 1306818596
Provider Name (Legal Business Name): SYLVIA M SEKHON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 COMO AVENUE MAIL STOP 31100A
ST PAUL MN
55108-1460
US

IV. Provider business mailing address

8100 34 AVE S
BLOOMINGTON MN
55425-1672
US

V. Phone/Fax

Practice location:
  • Phone: 651-641-6200
  • Fax: 651-641-6205
Mailing address:
  • Phone: 952-883-5463
  • Fax: 925-883-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24730
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: