Provider Demographics
NPI:1215323787
Name:BAMBENEK, MICHAEL H (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:BAMBENEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2829 UNIVERSITY AVE SE STE 730
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3279
Mailing Address - Country:US
Mailing Address - Phone:612-439-1868
Mailing Address - Fax:612-439-1860
Practice Address - Street 1:1575 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1126
Practice Address - Country:US
Practice Address - Phone:651-232-7348
Practice Address - Fax:612-439-1860
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2020-04-28
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Provider Licenses
StateLicense IDTaxonomies
MN63714207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine