Individual
DR. JOHN ROBERT PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12000 ELM CREEK BLVD N, #250, MAPLE GROVE, MN 55369-7073
(952) 401-8300
Mailing address
17705 HUTCHINS DR, #101, MINNETONKA, MN 55345-4145
(952) 401-8300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38883
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111714
UCARE
MN
01
—
1208118
MEDICA
MN
01
—
32Y76PA
BLUECROSS
MN
01
—
CP9041011314
PREFERRED ONE
MN
Enumeration date
02/01/2006
Last updated
07/09/2007
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