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1881677953

NPI Code Detail

MEDICARE: DR. LINA BANEVICIUTE MD

MEDICARE: DR. LINA BANEVICIUTE 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	207R00000X	Internal Medicine Physician	036112257	IL
2	207R00000X	Internal Medicine Physician	61993	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	:	1881677953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINA BANEVICIUTE MD

Provider Business Mailing Address
First Line	:	PO BOX 1309
Second Line	:	MS21110Q
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55440-1309
Country	:	US
Telephone Number	:	952-993-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5320 HYLAND GREENS DR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55437-3934
Country	:	US
Telephone Number	:	952-993-2400
Fax Number	:

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/21/2022

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Directions to “ DR. LINA BANEVICIUTE MD” Practice Location

Language	Start Address	Practice Location

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