Individual
PAUL R REMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Mailing address
4855 WEST ARROWHEAD ROAD, ESSENTIA HEALTH HERMANTOWN CLINIC, HERMANTOWN, MN 55811-3936
(218) 786-3540
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0247
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-04927
MEDICA
—
01
—
4F712RE
BCBSMN
MN
05
—
728252400
—
MN
01
—
C009
TRICARE WEST
—
01
—
CN1041011876
PREFERRED ONE
—
01
—
HP24108
HEALTHPARTNERS
—
Enumeration date
11/22/2005
Last updated
09/22/2016
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