Provider Demographics
NPI:1962473520
Name:CUNDY, KARA V (MD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:V
Last Name:CUNDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8100 34TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1672
Mailing Address - Country:US
Mailing Address - Phone:952-883-5463
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:2500 COMO AVE
Practice Address - Street 2:MAIL STOP 31100A
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1460
Practice Address - Country:US
Practice Address - Phone:651-641-6200
Practice Address - Fax:651-641-6205
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN37791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN367711700Medicaid
G05315Medicare UPIN
110005512Medicare ID - Type Unspecified