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NPI Code Detail

MEDICARE: DR. ALFRED CLAVEL JR. MD

MEDICARE: DR. ALFRED CLAVEL JR. 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
12084N0400XNeurology Physician33039MN

General Provider Information

NPI Number : 1841263696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFRED CLAVEL JR. MD
Provider Business Mailing Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-672-6000
Fax Number :
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1512
Country : US
Telephone Number : 612-672-6000
Fax Number : 612-273-9945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 07/26/2012

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