Individual
SUSAN L LALLI STREITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36727
MN
208000000X
Pediatrics Physician
36727
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32297600
—
WI
05
—
590820500
—
MN
Enumeration date
07/17/2006
Last updated
06/27/2011
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