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Individual

ADAM J BOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
900 NICOLLET MALL, TARGET CLINIC, MINNEAPOLIS, MN 55403-2530
(612) 338-0085
(612) 333-1026
Mailing address
3906 THOMAS AVE S, APARTMENT 4, MINNEAPOLIS, MN 55410-1236
(612) 590-4866
(612) 333-1026

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
PA810
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
403180099
ME
Enumeration date
10/28/2005
Last updated
07/08/2007
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