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Individual
PAUL M KIETZMANN
Active
Individual
PAUL M KIETZMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49324
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-30293 149780561
MEDICA
MN
01
—
1497880561
NPI
—
01
—
49324
STATE MEDICAL LICENSE
MN
05
—
925198000
—
MN
01
—
A086
TRI-CARE
MN
01
—
HP86106
HEALTH PARTNERS
MN
01
—
NA9121053818
PREFERRED ONE
MN
Enumeration date
02/22/2007
Last updated
10/21/2024
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