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Individual

SIMON HENRY LUETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232
Mailing address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11596
MN
363AS0400X
Surgical Physician Assistant
11596
MN
363AS0400X
Surgical Physician Assistant
3312-23
WI

Other

Enumeration date
04/18/2014
Last updated
04/20/2026
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