Provider Demographics
NPI:1184661944
Name:KANG, EUL S (MD)
Entity Type:Individual
Prefix:
First Name:EUL
Middle Name:S
Last Name:KANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 METRO BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3010
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:7505 METRO BLVD
Practice Address - Street 2:STE 400
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3010
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN241772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN22843OtherAMERICA'S PPO
MN1605168OtherMEDICA
MN08586KAOtherBLUE CROSS
MN100698OtherUCARE
WI300011426OtherRAILROAD MEDICARE WI
MN300085333OtherRAILROAD MEDICARE MN
MN0247007OtherPREFERRED ONE
MN029R3KAOtherBLUE CROSS
WI30311500Medicaid
MNHP13647OtherHEALTHPARTNERS
MN77620711Medicaid
MN08586KAOtherBLUE CROSS
MN1605168OtherMEDICA
MN22843OtherAMERICA'S PPO
MNHP13647OtherHEALTHPARTNERS
MN300002983Medicare PIN
WI000956135Medicare PIN