Beran, Mary Sue
Beran, Mary Sue is an individual health care provider with primary practice located at 15111 Twelve Oaks Center Dr , Minnetonka MN 55305-5201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Beran, Mary Sue can be contacted via phone (952) 993-4500.Contact Information
Primary practice address
15111 Twelve Oaks Center Dr
Minnetonka MN 55305-5201
Phone: (952) 993-4500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 40540 | Minnesota |
Profile Details
| NPI number | 1033196431 |
|---|---|
| LBN Legal business name | Beran, Mary Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2005 |
| Last updated | Feb 29th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033196431 | NPPES |
| Minnesota | MEDICAID | 056018900 |
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