Individual
TERRA SHOCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1983 SLOAN PL, SUITE 1, SAINT PAUL, MN 55117-2087
(651) 326-5700
(651) 326-5715
Mailing address
1292 VICTORIA ST N, SAINT PAUL, MN 55117-4035
(612) 616-3576
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46860
MN
Other
Enumeration date
07/02/2006
Last updated
07/08/2007
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