Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 47999 | MN |
NPI | 1023083805 |
---|---|
Provider Name | David Charles Nagel |
First Address | Minneapolis, MN 55454-1455 |
Second Address | Minneapolis, MN 55454-1455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 03/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
!42317 | (02) | MN |