Provider Demographics
NPI:1699855411
Name:LAVALLEUR, JUNE (MD)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:LAVALLEUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE MMC 395
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-273-7111
Mailing Address - Fax:
Practice Address - Street 1:6060 24TH AVENUE SOUTH
Practice Address - Street 2:RIVERSIDE PROFESSIONAL BUILDING, SUITE 300
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-273-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34622207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN023077400Medicaid
MN595947OtherARAZ
MN047027OtherFAIRVIEW
MN07-02800OtherMEDICA-PRIMARY
MN07-25339OtherMEDICA-CHOICE
MN100819OtherU CARE
MN2T434LAOtherBCBS
MN1000090OtherPREFERRED ONE
MN160026367OtherRR MEDICARE
MNHP13789OtherHEALTH PARTNERS
MN595947OtherARAZ
MN047027OtherFAIRVIEW