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NPI Code Detail

MEDICARE: MAKENZIE CHERVENY DO

MEDICARE: MAKENZIE CHERVENY DO
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
1207L00000XAnesthesiology Physician82676MN

General Provider Information

NPI Number : 1588307938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENZIE CHERVENY DO
Provider Business Mailing Address
First Line : 909 FULTON ST SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55455-4800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 909 FULTON ST SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55455-4800
Country : US
Telephone Number : 612-273-8383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 06/23/2026

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Directions to “ MAKENZIE CHERVENY DO” Practice Location

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