Provider Demographics
NPI:1386631539
Name:KNOEDLER, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:KNOEDLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6025 LAKE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1712
Mailing Address - Country:US
Mailing Address - Phone:651-999-6800
Mailing Address - Fax:651-999-6830
Practice Address - Street 1:1655 BEAM AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1163
Practice Address - Country:US
Practice Address - Phone:651-999-6896
Practice Address - Fax:651-770-8268
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-09-10
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Provider Licenses
StateLicense IDTaxonomies
MN32498208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN191595900Medicaid
MN191595900Medicaid
MNE10640Medicare UPIN