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Organization
DULUTH GRADUATE MEDICAL EDUCATION COUNCIL INC
Active
Organization
DULUTH GRADUATE MEDICAL EDUCATION COUNCIL INC
Active
Other names
Duluth Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHAILENDRA PRASAD MD (BOARD CHAIR)
(612) 624-7629
Entity
Organization
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32674900
—
WI
05
—
647010600
—
MN
01
—
69226FA
BCBSMN
MN
Enumeration date
11/16/2005
Last updated
05/24/2023
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