Individual
IOAN JOHN CHITU I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9553
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9553
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10322
MN
363AS0400X
Surgical Physician Assistant
10322
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10322
PA CERTIFICATION
MN
01
—
PAC0379
PA LICENSE
ND
Enumeration date
11/19/2007
Last updated
05/22/2008
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