Individual
MICHAEL BRIAN MACINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4946
(763) 586-5844
Mailing address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432
(763) 586-5844
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62828
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2012
Last updated
07/21/2022
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