Provider Demographics
NPI:1689834327
Name:JOGLEKAR, SIDDHARTH BHALCHANDRA (MD)
Entity Type:Individual
Prefix:MR
First Name:SIDDHARTH
Middle Name:BHALCHANDRA
Last Name:JOGLEKAR
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 1:913 E 26TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4515
Mailing Address - Country:US
Mailing Address - Phone:612-775-6257
Mailing Address - Fax:612-775-6105
Practice Address - Street 1:913 E 26TH ST STE 600
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4515
Practice Address - Country:US
Practice Address - Phone:612-775-6257
Practice Address - Fax:612-775-6105
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20581207X00000X
MN105122207X00000X
MN53361207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
MNENROLLEDMedicaid
IAENROLLEDMedicaid