Individual
ELISABETH REVOIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 E 1ST ST, STE LL, DULUTH, MN 55805-2297
(218) 722-5629
Mailing address
1000 E 1ST ST, STE LL, DULUTH, MN 55805-2297
(218) 722-5629
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
38650
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-00154
MEDICA
MN
01
—
1011800
PREFERRED ONE
MN
01
—
115834
UCARE
MN
01
—
160030895
RAILROAD MEDICARE
MN
01
—
32262000
MEDICAID
WI
01
—
38T68RE
BCBSM
MN
05
—
847326900
—
MN
01
—
A009
TRIWEST
MN
01
—
HP22609
HEALTH PARTNERS
MN
Enumeration date
06/02/2006
Last updated
12/04/2020
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