Individual
MICHAEL CHARLES MOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4855 W ARROWHEAD RD, HERMANTOWN, MN 55811-3936
(218) 786-3540
Mailing address
4855 W ARROWHEAD RD, HERMANTOWN, MN 55811-3936
(218) 786-3540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26996
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316563900
—
MN
Enumeration date
11/28/2006
Last updated
05/09/2011
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