Basic Information
Provider Information
NPI: 1932631959
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALINA
FirstName: MATTHEW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 701 PARK AVE
Address2: HENNEPIN COUNTY MEDICAL CENTER INTERNAL MEDICINE
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 701 PARK AVE
Address2: HENNEPIN COUNTY MEDICAL CENTER INTERNAL MEDICINE
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2017
LastUpdateDate: 07/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X67474MNY Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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