Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edward Gregory Walczak

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780258608

Edward Gregory Walczak is a Student in an Organized Health Care Education/Training Program in Minneapolis, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2021

Practice location Address checks out

420 Delaware Street SE Mmc 195
Minneapolis, MN 55455
Phone: (612) 625-6483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (MN)

Record details

NPI number1780258608
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 15, 2021
Last updated in NPPESMay 15, 2021
Certification dateApril 20, 2021
Mailing address420 Delaware Street Se, Mmc 195, Minneapolis, MN 55455

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