Individual
BLAKE NOENNIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416
(952) 993-3123
(952) 993-3286
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
(952) 993-3286
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
65775
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2014
Last updated
07/19/2019
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