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Organization

DERMATOLOGY PROFESSIONALS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL LUNDSTROM MD (PRESIDENT)
(218) 454-7546
Entity
Organization

Contact information

Practice address
1749 SE 2ND AVE, GRAND RAPIDS, MN 55744-2576
(218) 454-7546
(218) 454-0390
Mailing address
13359 ISLE DR STE 3, BAXTER, MN 56425-2223
(218) 454-7546
(218) 454-0390

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary

Other

Enumeration date
11/03/2022
Last updated
06/12/2024
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