Provider Demographics
NPI:1447224084
Name:MARMET, JORDAN GIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:GIL
Last Name:MARMET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-884-0649
Mailing Address - Fax:612-676-8992
Practice Address - Street 1:500 HARVARD ST SE
Practice Address - Street 2:UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0363
Practice Address - Country:US
Practice Address - Phone:612-273-3000
Practice Address - Fax:612-273-4370
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN45577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN132358OtherUCARE
MN501T9MAOtherBCBS
MN88965510Medicaid
MN1203084OtherMEDICA
MNCP9041040409OtherPREFERREDONE
MNI10481Medicare UPIN
MN370002943Medicare ID - Type UnspecifiedMEDICARE