Organization
LAKES AREA UROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BRIAN PAUL MD (PRESIDENT)
(218) 828-1418
Entity
Organization
Contact information
Practice address
1903 S 6TH ST, STE 3, BRAINERD, MN 56401
(218) 828-1418
(218) 833-8037
Mailing address
1903 S 6TH ST, STE 3, BRAINERD, MN 56401
(218) 828-1418
(218) 833-8037
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
739312100
—
MN
Enumeration date
02/03/2006
Last updated
02/16/2010
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