KEVIN D AMDAHL

JKA5 MAPLE GROVE INC

Dr KEVIN D AMDAHL is a male medical professional, specializing in Qualified Audiologist. He graduated in 1994 from University Of Wisconsin Medical School.

Contact

JKA5 MAPLE GROVE INC

7270 FORESTVIEW LN N
SUITE 160
MAPLE GROVE
MN
553695698

Tel: 3202520094

KEVIN D AMDAHL Information

Npi 1972624286
Pac Id 8123123890
Professional Enrollment Id I20070425000357
Last Name AMDAHL
First Name KEVIN
Middle Name D
Suffix
Gender M
Credential
Medical School Name UNIVERSITY OF WISCONSIN MEDICAL SCHOOL
Graduation Year 1994
Primary Specialty QUALIFIED AUDIOLOGIST
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name JKA5 MAPLE GROVE INC
Group Practice Pac Id 0244526515
Number Of Group Practice Members 2
Line 1 Street Address 7270 FORESTVIEW LN N
Line 2 Street Address SUITE 160
Marker Of Address Line 2 Suppression
City MAPLE GROVE
State MN
Zip Code 553695698
Phone Number 3202520094
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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