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Individual

JULIANA Y O'LAUGHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1515 SAINT FRANCIS AVE, SUITE 230, SHAKOPEE, MN 55379-3387
(952) 445-6700
Mailing address
12440 RIVERVIEW RD, EDEN PRAIRIE, MN 55347-4605

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44790
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0151762
MT
01
1040319
PREFERRED ONE
01
12-03552
MEDICA CHOICE
01
12-09026
MEDICA PRIMARY
01
131404
UCARE
05
34447200
MN
05
344720
WI
01
730T60L
BCBS
01
B710
CHAMPUS/TRICARE
Enumeration date
05/22/2006
Last updated
07/09/2007
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