Individual
DEBORAH KIM MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
409 N. DUNLAP ST., OPEN CITIES HEALTH CENTER, ST. PAUL, MN 55104
(651) 290-9200
(651) 290-9201
Mailing address
409 N. DUNLAP STREET, ST. PAUL, MN 55104
(651) 290-9200
(651) 290-9201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28770
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341875800
—
MN
Enumeration date
03/14/2006
Last updated
12/05/2013
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