Individual
DR. JODI SHARON MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6025 LAKE RD, SUITE 200, WOODBURY, MN 55125-1712
(651) 999-6800
(651) 999-6840
Mailing address
6025 LAKE RD, SUITE 200, WOODBURY, MN 55125-1712
(651) 999-6800
(651) 999-6840
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
53722
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00957098
MEDICARE RR
MN
Enumeration date
05/15/2009
Last updated
01/25/2015
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