Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 40757 | MN |
NPI | 1003867573 |
---|---|
Provider Name | Dr. Joseph J Martinelli |
First Address | Duluth, MN 55805-2201 |
Second Address | Duluth, MN 55805-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223695800 | (05) | MN |
H29519 | (02) | MN |