Individual
DR. PAUL DANIEL BASTIANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
3152 LYMAN ST, DULUTH, MN 55806-1147
(218) 461-2892
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126055
MN
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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