Individual
AMY L FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
290 MAIN ST NW, SUITE 100, ELK RIVER, MN 55330-1270
(763) 241-5805
(763) 241-5835
Mailing address
290 MAIN STREET, SUITE 100, ELK RIVER, MN 55330
(763) 241-5805
(763) 241-5835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46737
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053470600
—
MN
Enumeration date
02/15/2006
Last updated
07/06/2010
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