Basic Information
Provider Information
NPI: 1437252012
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAXENA
FirstName: RETU
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 OAKDALE AVE N
Address2: SUITE 200
City: MINNEAPOLIS
State: MN
PostalCode: 554222926
CountryCode: US
TelephoneNumber: 7635202000
FaxNumber: 7635202099
Practice Location
Address1: 3300 OAKDALE AVE N
Address2: SUITE 200
City: MINNEAPOLIS
State: MN
PostalCode: 554222926
CountryCode: US
TelephoneNumber: 7635202000
FaxNumber: 7635202099
Other Information
ProviderEnumerationDate: 09/07/2006
LastUpdateDate: 11/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X50447MNY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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