Individual
CHANAH M DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 SMITH AVE N, MAIL STOP 60241, SAINT PAUL, MN 55102-2344
(651) 241-8001
Mailing address
PO BOX 43, INTERNAL MAIL ROUTE 10017, MINNEAPOLIS, MN 55440-0043
(612) 262-3678
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40675
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853480200
—
MN
Enumeration date
06/28/2006
Last updated
04/02/2010
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