Guidera, Kenneth John

Guidera, Kenneth John is an individual health care provider with primary practice located at 2025 E River Pkwy , Minneapolis MN 55414-3604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, which is considered as his primary health care specialty. Guidera, Kenneth John can be contacted via phone (612) 596-6187.

Contact Information

Primary practice address
2025 E River Pkwy Minneapolis MN 55414-3604
Phone: (612) 596-6187
Fax: (612) 339-7634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X 47329 Minnesota

Profile Details

NPI number 1922150697
LBN Legal business name Guidera, Kenneth John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Apr 4th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922150697 NPPES
Minnesota MEDICAID 158417100
Minnesota MEDICAID 1922150697

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