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Individual

PAUL E YOUNGQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3960 COON RAPIDSBLVD, COON RAPIDS, MN 55433
(763) 236-9400
(763) 236-9423
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
(612) 262-4194

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22463
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
1841258928
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
614888300
MN
Enumeration date
05/01/2006
Last updated
08/19/2008
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