Ethan Benjamin Koch, MD | |
1601 Highway 13 E Ste 100, Burnsville, MN 55337-6847 | |
(952) 405-9760 | |
Not Available |
Full Name | Ethan Benjamin Koch |
---|---|
Gender | Male |
Speciality | Physical Medicine & Rehabilitation |
Location | 1601 Highway 13 E Ste 100, Burnsville, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023514007 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 71757 (Minnesota) | Secondary |
208100000X | Physical Medicine & Rehabilitation | 71757 (Minnesota) | Primary |
Entity Name | Sunny S Kim Md Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659301992 PECOS PAC ID: 5799788386 Enrollment ID: O20060822000124 |
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20200116002549 |
Mailing Address | Practice Location Address |
---|---|
Ethan Benjamin Koch, MD 1601 Highway 13 E Ste 100, Burnsville, MN 55337-6847 Ph: (952) 405-9760 | Ethan Benjamin Koch, MD 1601 Highway 13 E Ste 100, Burnsville, MN 55337-6847 Ph: (952) 405-9760 |
Dr. Svetlana Zaydman, D.O. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 2428 E 117th St, Burnsville, MN 55337 Phone: 612-444-3000 Fax: 612-444-9000 | |
Gregory P Gazzillo, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 14000 Fairview Dr, Burnsville, MN 55337 Phone: 952-993-8700 | |
Marlena Rose Mueller, DO Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 14101 Fairview Dr, Burnsville, MN 55337 Phone: 855-324-7843 |