Kallas, Kerry M
Kallas, Kerry M is an individual health care provider with primary practice located at 166 19Th Street South Suite 100, Sartell MN 56377-2154. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Kallas, Kerry M can be contacted via phone (320) 251-0609.Contact Information
Primary practice address
166 19Th Street South Suite 100
Sartell MN 56377-2154
Phone: (320) 251-0609
Fax: (320) 251-3806
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 40558 | Minnesota |
Profile Details
| NPI number | 1881661668 |
|---|---|
| LBN Legal business name | Kallas, Kerry M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Feb 15th, 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 | 1881661668 | NPPES |
| Minnesota | MEDICAID | 979669000 |
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