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Individual

DR. STEPHANIE J FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3100 KENNARD ST, MAPLEWOOD, MN 55109-5465
(651) 326-1044
Mailing address
3100 KENNARD ST, MAPLEWOOD, MN 55109-5465
(651) 326-1044

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
104273
MN
207K00000X
Allergy & Immunology Physician
Primary
52217
MN
208M00000X
Hospitalist Physician
2008008163
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
01
P0083991
MEDICARE RAIL ROAD
MN
Enumeration date
03/23/2007
Last updated
10/24/2011
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