Basic Information
Provider Information
NPI: 1497082051
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANDLER
FirstName: ZACHARY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 E 28TH ST
Address2: MEDICAL EDUCATION
City: MINNEAPOLIS
State: MN
PostalCode: 554073723
CountryCode: US
TelephoneNumber: 6126544096
FaxNumber:  
Practice Location
Address1: 8100 W 78TH ST
Address2:  
City: EDINA
State: MN
PostalCode: 554392516
CountryCode: US
TelephoneNumber: 9529148100
FaxNumber: 9529149101
Other Information
ProviderEnumerationDate: 11/03/2009
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X50842MNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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