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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 13 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 1033196431 NPPES
Minnesota MEDICAID 056018900

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