Organization
PAUL LARSON OB GYN CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN L. IMMERMAN M.D. (PRESIDENT)
(952) 927-4021
Entity
Organization
Contact information
Practice address
6525 FRANCE AVE S, STE 100, EDINA, MN 55435-3624
(952) 927-4021
(952) 285-6183
Mailing address
6525 FRANCE AVE S, STE 100, EDINA, MN 55435-2158
(952) 927-4021
(952) 285-6183
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
—
—
Other
Enumeration date
04/12/2006
Last updated
01/11/2012
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