Provider Demographics
NPI:1073583696
Name:TANSEK, KARIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:M
Last Name:TANSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 OAKDALE AVE N
Mailing Address - Street 2:150
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2948
Mailing Address - Country:US
Mailing Address - Phone:763-520-7840
Mailing Address - Fax:763-520-1578
Practice Address - Street 1:3366 OAKDALE AVE N
Practice Address - Street 2:150
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2948
Practice Address - Country:US
Practice Address - Phone:763-520-7840
Practice Address - Fax:763-520-1578
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN662273400Medicaid
MN040000516Medicare ID - Type UnspecifiedMEDICARE
MNA94288Medicare UPIN