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General NPI Number Information
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NPI Number | 1407844582
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Entity Type | Individual
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Provider Name | HERBERT L CANTRILL MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 3601 W 76TH ST STE 300
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City | EDINA
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State | MN
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Zip | 55435-6215
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Country | US
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Telephone | 952-897-1175
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Fax | 952-897-1178
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Provider Business Mailing Address
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Address Line | 7760 FRANCE AVE S STE 310
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City | MINNEAPOLIS
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State | MN
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Zip | 55435-5800
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Country | US
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Telephone | 952-897-1175
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Fax | 952-897-1178
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0239583
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License Number State | MN
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