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Contact Information

KOZHUVATTASSERI P MADHUSOODANAN, MD
516 DELAWARE STREET SE CLINIC 3B
UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS, MN55455
 Phone: 612-625-3600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KOZHUVATTASSERI P MADHUSOODANAN · (Male)

NPI # 1164505624
Status Active
Credentials MD
Entity Individual
Enumeration date 10/20/2006
Last updated 02/15/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 42532
  • IA Medicaid 0534461
  • MN Medicaid 128412600
  • ND Medicaid 10387
  • SD Medicaid 7777470
  • WI Medicaid 34017700
  • Other 1053385 ARAZ
  • Other HP31284 HEALTHPARTNERS
  • Other 25-00413 MEDICA CHOICE
  • Other 25-00021 MEDICA PRIMARY
  • Other 1024914 PREFERREDONE
  • Other M011 TRIWEST/TRICARE
  • Other 127916 UCARE
  • MN Other 78R23MA BLUE CROSS BLUE SHIELD
Hospital affiliation(s)
  • GRAND ITASCA CLINIC AND HOSPITAL - (Acute Care)
    1601 GOLF COURSE ROAD
    GRAND RAPIDS, MN 55744
  • HENNEPIN COUNTY MEDICAL CENTER - (Acute Care)
    701 PARK AVENUE
    MINNEAPOLIS, MN 55415
  • UNIVERSITY OF MINNESOTA MEDICAL CENTER FAIRVIEW - (Acute Care)
    2450 RIVERSIDE AVENUE
    MINNEAPOLIS, MN 55454
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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