MEDICARE: PAUL HOWARD KUNECK MD

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
1	207VE0102X	Reproductive Endocrinology Physician	31048	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1011034	OTHER	MN	PREFERRED ONE
2	HP13755	OTHER	MN	HEALTH PARTNERS
3	64G45KU	OTHER	MN	BLUE CROSS
4	26386	OTHER	MN	AMERICAS PRO
5	7425177	OTHER	MN	MEDICA

General Provider Information

NPI Number	:	1134178205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL HOWARD KUNECK MD

Provider Business Mailing Address
First Line	:	2828 CHICAGO AVE
Second Line	:	SUITE 400
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1544
Country	:	US
Telephone Number	:	612-863-5390
Fax Number	:	612-863-2697

Provider Business Practice Location Address
First Line	:	2828 CHICAGO AVE
Second Line	:	SUITE 400
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1544
Country	:	US
Telephone Number	:	612-863-5390
Fax Number	:	612-863-2697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/24/2009

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Directions to “ PAUL HOWARD KUNECK MD” Practice Location

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