Provider Demographics
NPI:1811424179
Name:MITTELSTEADT, DILIANA STOIMENOVA (MD)
Entity Type:Individual
Prefix:DR
First Name:DILIANA
Middle Name:STOIMENOVA
Last Name:MITTELSTEADT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DILIANA
Other - Middle Name:
Other - Last Name:STOIMENOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2829 UNIVERSITY AVE SE STE 730
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3279
Mailing Address - Country:US
Mailing Address - Phone:612-439-1869
Mailing Address - Fax:612-439-1860
Practice Address - Street 1:2855 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2649
Practice Address - Country:US
Practice Address - Phone:763-577-7160
Practice Address - Fax:763-577-7074
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66734207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine