Gomes, Maria De Lourdes Azevedo

Gomes, Maria De Lourdes Azevedo is an individual health care provider with primary practice located at 3300 Oakdale Ave N , Robbinsdale MN 55422-2926. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Gomes, Maria De Lourdes Azevedo can be contacted via phone (763) 559-2171.

Contact Information

Primary practice address
3300 Oakdale Ave N Robbinsdale MN 55422-2926
Phone: (763) 559-2171
Fax: (763) 694-9000
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 40553 Minnesota
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 40553 Minnesota
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 40553 Minnesota
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 40553 Minnesota

Profile Details

NPI number 1932109980
LBN Legal business name Gomes, Maria De Lourdes Azevedo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jun 26th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932109980 NPPES
Minnesota MEDICAID 993017500

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