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Individual

MR. BRIAN DAVID ZELICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
825 NICOLLET MALL, SUITE 1002, MINNEAPOLIS, MN 55402-2606
(612) 338-0711
(612) 332-3663
Mailing address
825 NICOLLET MALL, SUITE 1002, MINNEAPOLIS, MN 55402-2606
(612) 338-0711
(612) 332-3663

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
31389
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3683231-00
MN
Enumeration date
05/25/2006
Last updated
07/01/2010
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