Organization
OCCUPATIONAL AND MANUAL MEDICINE OF DULUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON OBST (MANAGER)
(218) 724-6002
Entity
Organization
Contact information
Practice address
1420 LONDON RD, SUITE 102B, DULUTH, MN 55805-2433
(218) 724-6002
Mailing address
1420 LONDON RD, SUITE 102B, DULUTH, MN 55805-2433
(218) 724-6002
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
30428
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264783400
—
MN
Enumeration date
07/03/2008
Last updated
07/03/2008
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