Takekoshi, Ken Julian

Takekoshi, Ken Julian is an individual health care provider with primary practice located at 1766 Trail Rd , Mendota Heights MN 55118-3730. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Takekoshi, Ken Julian can be contacted via phone (651) 756-0038.

Contact Information

Primary practice address
1766 Trail Rd Mendota Heights MN 55118-3730
Phone: (651) 756-0038
Fax: (651) 389-0175
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 4301076830 Michigan
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 56407-20 Wisconsin
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 54291 Minnesota
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036-114264 Illinois

Profile Details

NPI number 1841349149
LBN Legal business name Takekoshi, Ken Julian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Feb 13th, 2017 - about 9 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 1841349149 NPPES
Michigan MEDICAID 4991871
Michigan Other 220F160310

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