Individual
JOAN R LAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-8992
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
54951
MN
207R00000X
Internal Medicine Physician
54951
MN
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
54951
MN
Other
Enumeration date
06/19/2009
Last updated
01/19/2024
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