Maple Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43570 Issued in MN

Legal business name

MAPLE MEDICAL CENTER

Practice address

7261 Ohms LN
Edina, MN 55439-2148

Phone

(952) 843-4333

Fax

(952) 843-4301

NPI assigned

Apr 26, 2007

Last updated

Nov 9, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manan S Shukla, M.D.

Title

Ceo

Phone

(952) 843-4333

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1518187434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DRIVE, #105",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-420-0580",
            "fax_number": "763-420-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7261 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392148",
            "telephone_number": "952-843-4333",
            "fax_number": "952-843-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "SHUKLA",
        "authorized_official_first_name": "MANAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-843-4333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "43570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orrin Mann, MD
• Rachel Ann Mann, MD
• Kristine Mannchen, NP
• David L Manuel, MD
• James L. Manwill, MD
• Maps Applied Research Center, Inc.
• Jacklyn S Marburger, P.T.
• Philip Marcus, MD
• Hanna Marekegn
• Andrew Bruce Maresh, D O

• Internal Medicine Physician in Edina, MN
• Providers in Edina, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.