Individual
DR. GREGORY PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2355 HIGHWAY 36 W, STE 100, ROSEVILLE, MN 55113-3905
(952) 837-9700
(952) 837-9701
Mailing address
2355 HIGHWAY 36 W, STE 100, ROSEVILLE, MN 55113-3905
(952) 837-9700
(952) 837-9701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42558
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060928500
—
MN
Enumeration date
06/10/2006
Last updated
07/21/2021
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