MEDICARE: DR. VALDA NOREEN KAYE 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
1	207N00000X	Dermatology Physician	28050	MN
2	207ZD0900X	Dermatopathology (Pathology) Physician	28050	MN
3	207ZP0101X	Anatomic Pathology Physician	28050	MN

Other Identifiers

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

General Provider Information

NPI Number	:	1841293701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALDA NOREEN KAYE M.D.

Provider Business Mailing Address
First Line	:	9900 13TH AVENUE NORTH
Second Line	:	SUITE 2A
City	:	PLYMOUTH
State	:	MN
Zip	:	55441-5035
Country	:	US
Telephone Number	:	763-525-0363
Fax Number	:	763-525-0369

Provider Business Practice Location Address
First Line	:	9900 13TH AVENUE NORTH
Second Line	:	SUITE 2A
City	:	PLYMOUTH
State	:	MN
Zip	:	55441-5035
Country	:	US
Telephone Number	:	763-525-0363
Fax Number	:	763-525-0369

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/31/2014

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