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General NPI Number Information
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NPI Number | 1578768131
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Entity Type | Individual
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Provider Name | KUNAL MANOHAR PATEL
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Gender | Male
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 5775 WAYZATA BLVD STE 190
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2627
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Country | US
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Telephone | 952-541-1840
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Fax | 952-543-6524
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Provider Business Mailing Address
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Address Line | 5775 WAYZATA BLVD STE 400
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1271
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Country | US
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Telephone | 952-541-1840
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Fax | 952-543-6524
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 60302-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301090426
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 79257
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License Number State | MN
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