| NPI | 1861742918 |
|---|---|
| Doing Business As | STILLWATER MEDICAL GROUP MAHTOMEDI |
| Entity Type | Organization |
| Authorized Contact | ROSS BULLARD Director Of Finance 651-439-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 213E00000X Podiatrist | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2013-07-29 |