Individual
CAROL JEANNE SHOWALTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 SMITH AVE N, SUITE 737, SAINT PAUL, MN 55102-2424
(651) 241-8295
(651) 241-7300
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
32511
MN
208100000X
Physical Medicine & Rehabilitation Physician
38304
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32277500
—
WI
Enumeration date
04/05/2006
Last updated
07/08/2007
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