Individual
DR. PAUL A KETTLER
Active
Individual
DR. PAUL A KETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38222
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400483
MEDICA
MN
05
—
042717900
—
MN
01
—
08F53KE
BCBS OF MN
MN
01
—
1008503
PREFERRED ONE
MN
01
—
111163
UCARE
MN
01
—
21983
AMERICA'S PPO
MN
01
—
4648605
AETNA
MN
01
—
HP17709
HEALTHPARTNERS
MN
Enumeration date
04/19/2006
Last updated
05/10/2019
Update your record
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