Individual
MR. JAMES N CAVALLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-3230
(952) 993-7148
Mailing address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-3230
(952) 993-7148
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9864
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233642100
—
MN
Enumeration date
12/29/2005
Last updated
03/11/2019
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