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NPI Code Detail

MEDICARE: PATRICK M MENNING MD

MEDICARE: PATRICK M MENNING 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
12085R0202XDiagnostic Radiology Physician43730MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427021294
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK M MENNING MD
Provider Business Mailing Address
First Line : 6465 WAYZATA BLVD
Second Line : SUITE 210
City : MINNEAPOLIS
State : MN
Zip : 55426-1728
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6500 EXCELSIOR BLVD
Second Line : RADIOLOGY DEPT
City : MINNEAPOLIS
State : MN
Zip : 55426-4702
Country : US
Telephone Number : 952-993-5391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 08/10/2007

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