Provider Demographics
NPI:1346266574
Name:NI, OLIVER KANG-WEI (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:KANG-WEI
Last Name:NI
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 1:3601 MINNESOTA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5281
Mailing Address - Country:US
Mailing Address - Phone:612-879-1000
Mailing Address - Fax:612-879-1000
Practice Address - Street 1:3601 MINNESOTA DR STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5281
Practice Address - Country:US
Practice Address - Phone:612-879-1000
Practice Address - Fax:612-879-1000
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN623542084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100874150Medicare PIN
WI013857085Medicare PIN
I16116Medicare UPIN
WIP00432257Medicare PIN
I16116Medicare UPIN
WIP00432257Medicare PIN