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General NPI Number Information
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NPI Number | 1699863274
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Entity Type | Individual
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Provider Name | CLIFFORD E KASHTAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 516 DELAWARE ST SE PWB FOURTH FLOOR, ROOM 4-100
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-626-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE ST SE UNIVERSITY OF MINNESOTA PHYSICIANS MMC 491
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-626-6777
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Fax |
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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 | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | 28733
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License Number State | MN
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