Provider Demographics
NPI:1841293701
Name:KAYE, VALDA NOREEN (MD)
Entity type:Individual
Prefix:DR
First Name:VALDA
Middle Name:NOREEN
Last Name:KAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 13TH AVENUE NORTH
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-5035
Mailing Address - Country:US
Mailing Address - Phone:763-525-0363
Mailing Address - Fax:763-525-0369
Practice Address - Street 1:9900 13TH AVENUE NORTH
Practice Address - Street 2:SUITE 2A
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-5035
Practice Address - Country:US
Practice Address - Phone:763-525-0363
Practice Address - Fax:763-525-0369
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28050207N00000X, 207ZD0900X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN742780800Medicaid
220000744Medicare ID - Type Unspecified
MN742780800Medicaid