Individual
C ROWAN DEBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3622
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
33747
MN
Other
Enumeration date
12/05/2005
Last updated
03/01/2012
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