NPI 1225400104

Elias Cedillo, IDC

Practitioner Independent Duty Corpsman Minneapolis, MN

Practice location

Address: 5905 34th Ave S, Minneapolis, MN 55450-2900
Phone: (612) 713-4849

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1225400104
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Oct 2015
Record last updated: 30 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.