Provider Demographics
NPI:1659726941
Name:KNIER, STEPHEN RUDY (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RUDY
Last Name:KNIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3955 PARKLAWN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5660
Mailing Address - Country:US
Mailing Address - Phone:952-831-4454
Mailing Address - Fax:952-278-6947
Practice Address - Street 1:3955 PARKLAWN AVE STE 120
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5660
Practice Address - Country:US
Practice Address - Phone:952-831-4454
Practice Address - Fax:952-278-6947
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN65081208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics