Individual
MR. SAMUEL CARL GISSELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1801 NICOLLET AVE, MINNEAPOLIS, MN 55403-3791
(612) 823-2947
Mailing address
4954 XERXES AVE S STE 209, MINNEAPOLIS, MN 55410-2328
(612) 388-9573
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15416
MN
Other
Enumeration date
07/01/2025
Last updated
07/03/2025
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