Healthcare Provider Details

I. General information

NPI: 1255323358
Provider Name (Legal Business Name): KRISHNA M SAXENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S SPECIALTY CLINIC-DIABETES/ENDOCRINOLOGY-STPL 347 NORTH SMITH AVENUE
ST PAUL MN
55102
US

IV. Provider business mailing address

CHILDREN'S HEALTH CARE 2910 CENTRE POINTE DRIVE, 35-121A
ROSEVILLE MN
55113
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6818
  • Fax: 651-220-6064
Mailing address:
  • Phone: 651-855-2327
  • Fax: 651-855-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number18487
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: