DR. DAVID BROKL (NPI# 1306068150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306068150 |
| Entity Type | Individual |
| Full Name | DR. DAVID BROKL |
| Credential | M.D. |
| Practice Address |
6500 Excelsior Blvd Saint Louis Park MN 55426-4702 |
| Practice Telephone | 9529933246 |
| Mailing Telephone | 9529933246 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD428755 | PA | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
54054 | MN | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
TP105344 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DEA | FB2542404 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1025 Marsh St, Mankato, MN 560014752 | 5073854700 |
| Street Address |
6500 EXCELSIOR BLVD |
| City | SAINT LOUIS PARK |
| State | MN |
| Zip Code | 55426-4702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588014831 | Jessica Gore | Speech-Language Pathologist | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2016-06-17 |
| 1245664630 | Erin Elizabeth Lalley | Nurse Practitioner | 6500 Excelsior Blvd, Suite 4-820, Saint Louis Park, MN 55426-4702 | 2013-08-21 |
| 1831535558 | Adrianne Rose Mallen | Obstetrics & Gynecology | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2013-05-21 |
| 1447696760 | Gerri Lee Clements | Advanced Practice Midwife | 6500 Excelsior Blvd, Hvc 5th Floor, Saint Louis Park, MN 55426-4702 | 2013-05-14 |
| 1003196148 | Chelsey Marie Peters | Occupational Therapist | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2011-08-21 |
| 1164757035 | Jennifer M Neist | Registered Nurse | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2009-10-12 |
| 1144490400 | Andrea Marie Kinzer | Occupational Therapist | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2008-03-03 |
| 1659494342 | Jason Christopher Carvalho | Pathology | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2007-04-09 |
| 1053439497 | Tina Patricia Lavin | Speech-Language Pathologist | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2007-03-26 |
| 1609912740 | Mariana J Canoniero | Internal Medicine | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457795775 | Tyson Sievers | Internal Medicine | 406 Harvard St Se, Mmc 36, Minneapolis, MN 55455-0362 | 2013-04-18 |
| 1114269461 | Sachin Mohan | Internal Medicine | 640 Jackson St # Mc11503f, Saint Paul, MN 55101-2502 | 2013-03-25 |
| 1609011949 | Elizabeth Fallon | Internal Medicine | 2550 University Ave West Suite 423 South, Minneapolis, MN 55114-1904 | 2008-12-15 |
| 1780829440 | Albert Dallas Newcomer | Internal Medicine | 437 Eagle Ln Sw, Rochester, MN 55902-4137 | 2008-12-10 |
| 1528215415 | Ronald F Kettering | Internal Medicine | 1635 11th Ave Ne, Rochester, MN 55906-4266 | 2008-08-21 |
| 1710147392 | Ridgeview Clinics | Internal Medicine | 560 South Maple Street, Suite 220, Waconia, MN 55387-0000 | 2008-06-17 |
| 1265609085 | Jeffrey Sanders | Internal Medicine | 1185 Town Centre Dr #205, Eagan, MN 55123-1343 | 2008-05-12 |
| 1467640482 | Metropolitan Gastrointestinal Specialists | Internal Medicine | 17322 91st Ave N, Maple Grove, MN 55311-5403 | 2007-10-04 |
| 1144412503 | Paul R Dambowy | Internal Medicine | 1973 Sloan Pl Ste 100, Saint Paul, MN 55117-2085 | 2007-08-09 |
| 1598962656 | Maria E Moscandrew | Internal Medicine | 825 S 8th St Ste 250, Minneapolis, MN 55404-1214 | 2007-06-29 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS PARK |
| Zip Code | 55426 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.