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Individual

DR. MICHAEL EARL MAUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
415 BLAKE RD N, SUITE 240, HOPKINS, MN 55343-8108
(952) 814-0207
(952) 938-8838
Mailing address
2521 HUMBOLDT AVE S APT 108, MINNEAPOLIS, MN 55405-3528
(612) 377-6113

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0574
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1306039854
BLUECROSS BLUESHIELD OF MINNESOTA
MN
05
1306039854
MN
Enumeration date
08/18/2007
Last updated
08/23/2009
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