Provider Demographics
NPI:1134178205
Name:KUNECK, PAUL HOWARD (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:HOWARD
Last Name:KUNECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 CHICAGO AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1544
Mailing Address - Country:US
Mailing Address - Phone:612-863-5390
Mailing Address - Fax:612-863-2697
Practice Address - Street 1:2828 CHICAGO AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1544
Practice Address - Country:US
Practice Address - Phone:612-863-5390
Practice Address - Fax:612-863-2697
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31048207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1011034OtherPREFERRED ONE
MNHP13755OtherHEALTH PARTNERS
MN64G45KUOtherBLUE CROSS
MN26386OtherAMERICAS PRO
MN7425177OtherMEDICA