Individual
DR. PAUL J SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4465 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN 55110
(651) 653-0062
(651) 653-0288
Mailing address
4465 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN 55110
(651) 653-0062
(651) 653-0288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31236
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282503100
—
MN
Enumeration date
08/09/2005
Last updated
07/21/2022
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