Provider Demographics
NPI:1669445466
Name:HELOU, EMELIE F (MD)
Entity Type:Individual
Prefix:
First Name:EMELIE
Middle Name:F
Last Name:HELOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-1208
Mailing Address - Country:US
Mailing Address - Phone:612-636-8763
Mailing Address - Fax:
Practice Address - Street 1:6520 CREEK DR
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1208
Practice Address - Country:US
Practice Address - Phone:612-636-8763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN44716207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN332178900Medicaid
H65788Medicare UPIN
MN110238044Medicare ID - Type UnspecifiedRAILROAD
MN332178900Medicaid