Provider Demographics
NPI:1215037080
Name:MINENKO, ANNE G (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:G
Last Name:MINENKO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:420 DELAWARE STREET SE, MMC 108
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-625-8690
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:PWB SIXTH FLOOR, CLINIC 6A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0356
Practice Address - Country:US
Practice Address - Phone:612-625-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-31
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Provider Licenses
StateLicense IDTaxonomies
MN42698207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN010905300Medicaid
MN1023931OtherPREFERRED ONE
MNHP31270OtherHEALTH PARTNERS
MN1031133OtherARAZ
WI34012200Medicaid
MN127830OtherUCARE
MN32-00003OtherMEDICA PRIMARY
1031133OtherARAZ
MN77R66MIOtherBLUE CROSS BLUE SHIELD
MN32-00055OtherMEDICA CHOICE
MN32-00055OtherMEDICA CHOICE