Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 52408 | MN |
N | 208800000X | Urologist | 52408 | MN |
NPI | 1043403363 |
---|---|
Provider Name | Dr. Joshua Lane Woelk |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55108-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 13/09/2021 |