Provider Demographics
NPI:1841810223
Name:KUE, KENCHIRO (DO)
Entity type:Individual
Prefix:
First Name:KENCHIRO
Middle Name:
Last Name:KUE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 43 MR 10860
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-0043
Mailing Address - Country:US
Mailing Address - Phone:612-262-1166
Mailing Address - Fax:612-262-9035
Practice Address - Street 1:17489 DODD BLVD
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6410
Practice Address - Country:US
Practice Address - Phone:952-428-1020
Practice Address - Fax:952-428-1025
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-25
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN763562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry