MICHAEL WYNN PROVINES

EDINA, MN
NPI1568230001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: NY  220655-01)
Enumeration Date2023-12-14
Last Update Date2023-12-14
Business Address
MICHAEL WYNN PROVINES MD
4201 DUNBERRY LN
EDINA, MN 55435-1603
Phone number: 954-496-2260
Mailing Address
MICHAEL WYNN PROVINES MD
4201 DUNBERRY LN
EDINA, MN 55435-1603
Phone number: 954-496-2260
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