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Individual

DR. SAMUEL JESSE ANTHONY II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2401 FAIRVIEW AVE N STE 145, ROSEVILLE, MN 55113-2710
(888) 290-1209
(833) 973-3529
Mailing address
20515 ASPEN DR, GRAND RAPIDS, MN 55744-4792

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76012
MN

Other

Enumeration date
05/07/2019
Last updated
07/23/2025
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