Individual
DR. MARY JO CRISSLER BELANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45697
MN
207R00000X
Internal Medicine Physician
Primary
60515
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406200
MEDICA
MN
01
—
172K2CR
BC BS
MN
01
—
585241040263
PREFERRED ONE
MN
05
—
772660100
—
MN
Enumeration date
05/13/2006
Last updated
06/02/2015
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