Individual
PETER J BOOSALIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4585
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
41145
MN
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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