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Individual

JONATHAN BIEBL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3580 ARCADE ST, VADNAIS HEIGHTS, MN 55127-7135
(651) 968-5770
(651) 968-5775
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5042
(651) 968-5904

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23233
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200023909
RAILROAD MEDICARE
MN
05
351567200
MN
Enumeration date
03/17/2006
Last updated
07/01/2015
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