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Organization
PAUL LARSON OB GYN CLINIC PA
Active
Organization
PAUL LARSON OB GYN CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN L. IMMERMAN M.D. (PRESIDENT)
(952) 927-4021
Entity
Organization
Contact information
Practice address
6525 FRANCE AVE S, STE 100, EDINA, MN 55435-3624
(952) 927-4021
(952) 285-6183
Mailing address
6525 FRANCE AVE S, STE 100, EDINA, MN 55435-2158
(952) 927-4021
(952) 285-6183
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
—
—
Other
Enumeration date
04/12/2006
Last updated
01/11/2012
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