Provider Demographics
NPI:1366522245
Name:LAKSHMINARAYAN, KAMAKSHI (MD)
Entity type:Individual
Prefix:
First Name:KAMAKSHI
Middle Name:
Last Name:LAKSHMINARAYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAMAKSI
Other - Middle Name:
Other - Last Name:LAKSHMINARAYANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:420 DELAWARE ST SE MMC 295
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-3004
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:PWB FIRST FLOOR, CLINIC 1A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0356
Practice Address - Country:US
Practice Address - Phone:612-626-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN426782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN155408OtherFAIRVIEW
MN05-00009OtherMEDICA-PRIMARY
MN319742500Medicaid
MN1031480OtherPREFERRED ONE
MN142279OtherU CARE
1692245OtherARAZ
MN05-00253OtherMEDICA-CHOICE
MNHP37200OtherHEALTH PARTNERS
MN155408OtherFAIRVIEW