Individual
CAROL PHILIPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369
(952) 993-1440
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
65906
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2015
Last updated
03/10/2021
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