Individual
MICHAEL JOSEPH MCGREGOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11661
MN
363A00000X
Physician Assistant
PAC0164
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71074
—
ND
Enumeration date
07/17/2006
Last updated
05/04/2017
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