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NPI Verification

National Provider Identifier: 1740403393

Adult Medicine PA

Organization

Primary Specialty

Dietitian, Registered

Code: 133V00000X

All Specialties (2)

Internal Medicine

Code: 207R00000X

Dietitian, Registered

Code: 133V00000X

Primary

Practice Address

393 DUNLAP ST N STE 235

SAINT PAUL, MN 551044208

Phone: 651-644-7775

NPI Enumeration Date

April 11, 2007

NPI Number

1740403393

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry