Provider Demographics
NPI:1003960006
Name:VANBEEK, ALLEN LESTER (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:LESTER
Last Name:VANBEEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7373 FRANCE AVE S
Mailing Address - Street 2:SUITE 510
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4534
Mailing Address - Country:US
Mailing Address - Phone:952-830-1028
Mailing Address - Fax:952-830-0091
Practice Address - Street 1:7373 FRANCE AVE S
Practice Address - Street 2:SUITE 510
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4534
Practice Address - Country:US
Practice Address - Phone:952-830-1028
Practice Address - Fax:952-830-0091
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN25914208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN251502400Medicaid
MN251502400Medicaid
MN240000017Medicare ID - Type UnspecifiedPHYSICIAN