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Organization
NOBLE PARKWAY MEDICAL CLINIC PROFESSIONAL CORPORATION
Active
Organization
NOBLE PARKWAY MEDICAL CLINIC PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAJUDEEN O FAWOLE MD (CEO)
(763) 496-1562
Entity
Organization
Contact information
Practice address
4808 85TH AVE NORTH, SUITE 300, BROOKLYN PARK, MN 55443
(763) 496-1562
(763) 657-0581
Mailing address
4808 85TH AVE NORTH, SUITE 300, BROOKLYN PARK, MN 55443
(763) 496-1562
(763) 657-0581
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2013
Last updated
05/16/2013
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