Individual
JUAN OLIVER MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4946
(763) 572-5700
Mailing address
1700 UNIVERSITY AVE W FL 6, SAINT PAUL, MN 55104-3727
(651) 232-1123
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
71210
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2018
Last updated
07/25/2023
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