Individual
DR. JOHN PHILIP WUST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10705 TOWN SQUARE DR NE STE 100, BLAINE, MN 55449-8185
(763) 236-5400
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
38586
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266318000
—
MN
Enumeration date
08/09/2005
Last updated
11/13/2011
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