Individual
RICHARD GERARD MAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 JACKSON ST, MC 11109E, SAINT PAUL, MN 55101-2502
(651) 254-9545
(651) 254-3662
Mailing address
8170 33RD AVE S, MAIL STOP 21110Q, BLOOMINGTON, MN 55425-4516
(651) 254-9545
(651) 254-3662
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36096
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
932065200
—
MN
Enumeration date
02/06/2006
Last updated
12/12/2014
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