Individual
DR. JAKE RICHARD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E SUPERIOR ST, SUITE L401, DULUTH, MN 55802-2207
(218) 249-7960
(218) 249-7997
Mailing address
915 E 1ST ST, DULUTH, MN 55805-2107
(218) 249-7960
(218) 249-7997
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
43769
MN
208M00000X
Hospitalist Physician
Primary
43769
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
478948200
—
MN
Enumeration date
05/12/2006
Last updated
12/04/2020
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