Individual
DR. CHARLES OWEN GENSMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-8992
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-1166
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
26057
MN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
26057
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
829802500
—
MN
Enumeration date
01/25/2007
Last updated
11/10/2020
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