DERIK K KENWORTHY DO
Individual Provider (NPI-1)
Active
Radiology, Diagnostic Radiology
Provider Information
- NPI Number
1861726077- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DO
- Status
- Active
Contact & Location
- Address
- 3600 MINNESOTA DR STE 800, EDINA, MN, 554357915
- Phone
- (952) 595-1100
- Fax
- (612) 294-4903
Specialties & Taxonomies
Radiology, Diagnostic Radiology
License: KS #05-50096
Radiology, Diagnostic Radiology
License: FL #OS21657
Radiology, Diagnostic Radiology
License: MT #MED-PHYS-LIC-148473
Radiology, Diagnostic Radiology
License: TX #V3891
Radiology, Diagnostic Radiology
License: OK #8833
Radiology, Diagnostic Radiology
License: CO #DR.0074105
Radiology, Diagnostic Radiology
License: UT #14225604-1204
Radiology, Diagnostic Radiology
Primary License: OR #DO220167