Individual
AUTUMN MONTVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(612) 813-6000
Mailing address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(612) 813-6000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
29302
MN
208000000X
Pediatrics Physician
Primary
66038
MN
Other
Enumeration date
04/16/2018
Last updated
11/10/2022
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