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NPI Code Detail

MEDICARE: MICHAEL J AYLWARD M.D.

MEDICARE: MICHAEL J AYLWARD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician46931MN
2208000000XPediatrics Physician46931MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
204-00123OTHERMEDICA PRIMARY
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
404-08320OTHERMEDICA CHOICE

General Provider Information

NPI Number : 1053366575
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J AYLWARD M.D.
Provider Business Mailing Address
First Line : UNIVERSITY OF MINNESOTA PHYSICIANS
Second Line : 420 DELAWARE ST SE, MMC 136
City : MINNEAPOLIS
State : MN
Zip : 55455
Country : US
Telephone Number : 612-624-9499
Fax Number :
Provider Business Practice Location Address
First Line : 2001 BLOOMINGTON AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3074
Country : US
Telephone Number : 612-638-0700
Fax Number : 612-627-4205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 10/23/2014

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