Individual
BRIAN L TELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4040 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 427-9980
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31419
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9628887800
—
MN
Enumeration date
02/17/2006
Last updated
11/22/2011
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