Individual
BRIAN GERARD PROKOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 SMITH AVE N, SUITE 4314A, SAINT PAUL, MN 55102-2344
(651) 241-8436
(651) 241-2793
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31739
MN
Other
Enumeration date
04/07/2006
Last updated
03/11/2021
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