Individual
MARY E CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
640 JACKSON ST, MC 11102F, SAINT PAUL, MN 55101-2502
(651) 254-3456
(651) 254-5216
Mailing address
8100 34TH AVE S, MC21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7172
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29846
MN
207P00000X
Emergency Medicine Physician
40483
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716078000
—
MN
Enumeration date
03/07/2006
Last updated
01/12/2015
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