Individual
JON I MCIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6600
(952) 883-9677
Mailing address
10016 INDIGO DR, EDEN PRAIRIE, MN 55347-1206
(612) 751-1414
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
42697
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
649666100
—
MN
Enumeration date
01/17/2006
Last updated
11/15/2022
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