DR. GARY L BRUNKOW (NPI# 1558367847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558367847 |
| Entity Type | Individual |
| Full Name | DR. GARY L BRUNKOW |
| Credential | MD |
| Practice Address |
6545 France Avenue South Suite 510 Edina MN 55435 |
| Practice Telephone | 9529277079 |
| Practice Fax Number | 9529209758 |
| Mailing Telephone | 9529277079 |
| Mailing Fax Number | 9529209758 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2009-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 24253 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 885305300 | 05 | |
| MN | MEDICARE | 110000656 | 01 |
| Street Address |
6545 FRANCE AVENUE SOUTH SUITE 510 |
| City | EDINA |
| State | MN |
| Zip Code | 55435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509255 | David J Walcher | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| 1821210212 | Jacob Charles Liston | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2007-05-03 |
| 1437233525 | Mary L Maki Setre | Nurse Practitioner | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-10-25 |
| 1346207149 | Southdale Internal Medicine Pa | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2006-04-27 |
| 1417924614 | Elisa M Wright | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-07 |
| 1659348399 | Mary Anne Jacob | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-01 |
| 1598730756 | Juan C Angelats | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-02-21 |
| 1053317354 | Merlin Emery Brown | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023644069 | Jeffrey Howard Mandel | Internal Medicine | 6204 Westridge Blvd, Edina, MN 55436-2569 | 2020-03-22 |
| 1164718607 | Christine Nichole Desautels | Internal Medicine | 8100 W. 78th St. #100, Edina, MN 55439-2529 | 2011-06-23 |
| 1598887895 | Ahmad Raza | Internal Medicine | 6363 France Ave S Ste 610, Edina, MN 55435-2144 | 2007-04-06 |
| 1427118975 | Noelle M Nelson | Internal Medicine | 8100 W 78th St # St100, Edina, MN 55439-2516 | 2006-12-12 |
| 1962583658 | Jean Ruth Eckerly | Internal Medicine | 5808 Zenith Ave S, Edina, MN 55410-2832 | 2006-10-18 |
| 1578518767 | Mary Jane Setterberg | Internal Medicine | 6700 France Ave S Ste 300, Edina, MN 55435-1908 | 2006-05-24 |
| 1871554048 | Kathleen M Ayaz | Internal Medicine | 8100 W 78th St Ste 100, Edina, MN 55439-2529 | 2006-03-29 |
| 1003809898 | Mohammad H Arbabi | Internal Medicine | 6500 France Ave S, Edina, MN 55435-1700 | 2005-08-26 |
| 1972509255 | David J Walcher | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| 1578569042 | Paul S. Gotlieb | Internal Medicine | 6545 France Ave S, Suite 150, Edina, MN 55435-2131 | 2005-06-21 |
| Find all providers in EDINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.