Individual provider · Type 1 NPI

Marson Rubianto Eka Putra, MD, PhD

Student in an Organized Health Care Education/Training Program · Minneapolis, MN

NPI number 1659169704 Active

Practice location

420 Delaware St SE
Minneapolis, MN 55455-0341

Call (612) 625-1969 Map

Fax (612) 625-7950

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1659169704

Marson Rubianto Eka Putra, MD, PhD's National Provider Identifier is 1659169704, issued on Apr 29, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Minneapolis, MN. The record was last updated on Apr 29, 2025.