Individual
MARY JOY L SIA SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 251-2700
Mailing address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44485
MN
208M00000X
Hospitalist Physician
Primary
44485
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690922100
—
MN
Enumeration date
07/07/2006
Last updated
03/11/2021
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