Provider Demographics
NPI:1174551931
Name:YONKE, BRET DAVID (MD)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:DAVID
Last Name:YONKE
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 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2232
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2232
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN484162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN399K5YOOtherBLUE CROSS BLUE SHIELD
MN133063OtherUCARE
MN2443397OtherAMERICA'S PPO
MNP00380140OtherRAILROAD MEDICARE MN
MN1047090OtherPREFERRED ONE
MN1604184OtherMEDICA
WI34786700Medicaid
MN516720500Medicaid
MNHP64741OtherHEALTHPARTNERS
MN2443397OtherAMERICA'S PPO
MN1604184OtherMEDICA
MN516720500Medicaid