REID KENNETH MIMMACK MD
Individual Provider (NPI-1)
Active
Anesthesiology
Provider Information
- NPI Number
1861070948- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 701 PARK AVE, MINNEAPOLIS, MN, 554151623
- Phone
- (612) 873-3000
Specialties & Taxonomies
Student in an Organized Health Care Education/Training Program
Anesthesiology
Primary License: MN #79473