Provider Demographics
NPI:1871865840
Name:TEMPERO, KENNETH FLOYD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:FLOYD
Last Name:TEMPERO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-9715
Mailing Address - Country:US
Mailing Address - Phone:952-476-9024
Mailing Address - Fax:952-476-9026
Practice Address - Street 1:1901 LAKE RD
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-9715
Practice Address - Country:US
Practice Address - Phone:952-476-9024
Practice Address - Fax:952-476-9026
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18570207RR0500X, 208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology