Individual
MADELINE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 HAZELWOOD ST STE 100, MAPLEWOOD, MN 55109-1242
(651) 232-7800
Mailing address
400 STINSON BLVD FL 2, REV MGMT PROVIDER ENROLLMENT, MINNEAPOLIS, MN 55413-2614
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
66929
MN
Other
Enumeration date
04/10/2017
Last updated
07/20/2020
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