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Individual

DR. CHAROEN MANKONGPAISARNRUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
435 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-8680
(651) 254-8656
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
10178
SD
207RG0100X
Gastroenterology Physician
Primary
70746
MN
207RG0100X
Gastroenterology Physician
MD042302
DC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/07/2011
Last updated
07/21/2022
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