Individual
DR. PHILIP J FALLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1020 W BROADWAY, MINNEAPOLIS, MN 55411-2504
(612) 302-8200
(612) 302-8275
Mailing address
1020 W BROADWAY, MINNEAPOLIS, MN 55411-2504
(612) 302-8200
(612) 302-8275
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
31855
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349388100
—
MN
Enumeration date
07/27/2006
Last updated
02/16/2010
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