Individual
MITCHELL VINCENT GOSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
628 ROOSEVELT RD STE 101, SAINT CLOUD, MN 56301-4867
(320) 774-3789
(320) 774-3483
Mailing address
628 ROOSEVELT RD STE 101, SAINT CLOUD, MN 56301-4867
(320) 774-3789
(320) 774-3483
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35396
MN
207WX0109X
Neuro-ophthalmology Physician
35396
MN
Other
Enumeration date
06/02/2006
Last updated
03/09/2018
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