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Individual

DR. MICHAEL THOMAS PADDOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
640 JACKSON STREET, MS11102F, ST. PAUL, MN 55101-2502
(651) 254-3456
(651) 254-5216
Mailing address
PO BOX 1309 - 8170 33RD AVE S, MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 254-3456
(651) 254-5216

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036131957
IL
207P00000X
Emergency Medicine Physician
Primary
108311
MN
207P00000X
Emergency Medicine Physician
64249
WI

Other

Enumeration date
07/04/2010
Last updated
05/13/2019
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