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Miss SUSAN MARGARET LOU

Individual Provider (NPI-1) Active

Internal Medicine, Gastroenterology

Provider Information

NPI Number
1316387277
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
640 JACKSON ST, SAINT PAUL, MN, 551012502
Phone
(651) 254-3242
Fax
(651) 254-1553

Specialties & Taxonomies

Internal Medicine License: MN #63005
Internal Medicine, Gastroenterology Primary License: MN #63005

All Addresses

LOCATION

640 JACKSON ST

SAINT PAUL, MN, 551012502

(651) 254-3242

MAILING

8170 33RD AVE S MS 21110Q

BLOOMINGTON, MN, 554254516