Individual
DR. MICHAEL B DEBRULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6600 LYNDALE AVE S, SUITE#130, RICHFIELD, MN 55423-3380
(612) 788-8778
Mailing address
6600 LYNDALE AVE S, SUITE#130, RICHFIELD, MN 55423-3380
(612) 788-8778
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
MN679
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689655722
—
MN
01
—
59G29DE
BCBS OF MN
MN
05
—
6800620
—
SD
Enumeration date
11/07/2005
Last updated
10/29/2018
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