Individual
OMRI SHOCHATOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3025
(952) 993-1937
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33160
MN
Other
Enumeration date
12/27/2005
Last updated
03/07/2012
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