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Individual

DR. DOUGLAS NEAL MELLINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 656-7020
(320) 255-5943
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 656-7020
(320) 255-5943

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
20A8396
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
68816
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX83960
CA
Enumeration date
08/16/2006
Last updated
03/26/2021
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