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Individual

DR. CHARLES LEDUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
504 E 63RD ST, 28 L, NEW YORK, NY 10065-7919
(343) 333-4379

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
273255-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58804
MINNESOTA STATE MEDICAL LICENSE
MN
Enumeration date
11/07/2014
Last updated
06/08/2015
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