Cervenka, Richard Peter

Cervenka, Richard Peter is an individual health care provider with primary practice located at 3790 117Th Ln Nw , Coon Rapids MN 55433-2666. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Cervenka, Richard Peter can be contacted via phone (763) 421-7300.

Contact Information

Primary practice address
3790 117Th Ln Nw Coon Rapids MN 55433-2666
Phone: (763) 421-7300
Fax: (763) 421-3337
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 304 Minnesota

Profile Details

NPI number 1306832464
LBN Legal business name Cervenka, Richard Peter
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated May 10th, 2017 - about 7 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 1306832464 NPPES
Minnesota MEDICAID 042325400
Minnesota Other 34039CE

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