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Individual

DR. JOHN P LOES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3883 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 421-2273
(763) 421-2236
Mailing address
14569 WACO ST NW, RAMSEY, MN 55303-6181
(763) 421-7988

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30144
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30144
STATE LICENSE
MN
Enumeration date
06/26/2007
Last updated
07/08/2007
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