Individual
STEVEN MOUACHEUPAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8170 33RD AVE S, MAIL STOP 21110Q, MINNEAPOLIS, MN 55440-1309
(651) 523-9800
Mailing address
2165 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2707
(651) 523-9800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44776
MN
Other
Enumeration date
04/20/2006
Last updated
05/04/2017
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