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Contact Information

KEN J TAKEKOSHI, MD
1766 TRAIL RD
MENDOTA HEIGHTS, MN55118-3730
 Phone: 651-756-0038
 Fax: 651-389-0175
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for KEN J TAKEKOSHI · (Male)

NPI # 1841349149
Status Active
Credentials MD
Entity Individual
Enumeration date 01/09/2007
Last updated 02/13/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-114264
  • MI License # 4301076830
  • MN License # 54291
  • WI License # 56407-20
  • MI Medicaid 4991871
  • MI Other 220F160310 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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