Individual
JASON R MAXWELL-WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 COMO AVE, SAINT PAUL, MN 55108
(651) 641-6200
(651) 641-6205
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45055
MN
Other
Enumeration date
03/14/2006
Last updated
08/18/2021
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