Individual
PAUL PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-1166
(612) 262-4258
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
(612) 262-4259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64548
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/20/2016
Last updated
06/04/2020
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