Individual
CAROL A SOUTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 PHALEN BLVD - MS 41102B, HEALTHPARTNERS SPECIALTY CENTER 401, ST. PAUL, MN 55130-5302
(651) 254-7580
(651) 254-7584
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(651) 254-7584
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24028
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
841582000
—
MN
Enumeration date
02/27/2006
Last updated
12/14/2011
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