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1770348898
MAXINE ANNE FUSARO
SAINT PAUL, MN
NPI
1770348898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 14820)
Enumeration Date
2024-02-19
Last Update Date
2024-02-19
Business Address
MAXINE ANNE FUSARO PA-C
640 JACKSON ST
SAINT PAUL, MN 55101-2595
Phone number: 651-254-3456
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Mailing Address
MAXINE ANNE FUSARO PA-C
16855 N MANOR RD
EDEN PRAIRIE, MN 55346-2227
Phone number: 612-619-3290
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