Demanivel, Kathleen Maccarthy
Demanivel, Kathleen Maccarthy is an individual health care provider with primary practice located at 14500 99Th Ave N , Maple Grove MN 55369-4478. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Demanivel, Kathleen Maccarthy can be contacted via phone (763) 898-1000.Contact Information
Primary practice address
14500 99Th Ave N
Maple Grove MN 55369-4478
Phone: (763) 898-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 31117 | Minnesota |
Profile Details
| NPI number | 1477543957 |
|---|---|
| LBN Legal business name | Demanivel, Kathleen Maccarthy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Aug 13th, 2012 - about 12 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 | 1477543957 | NPPES |
| Minnesota | MEDICAID | 550507100 |
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