Individual
DR. BRENT R CHAMBERLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3246
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
44930
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
983120700
—
MN
Enumeration date
12/29/2005
Last updated
03/01/2012
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