Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 36456 | MN |
Y | 2081P2900X | Pain Medicine | 36456 | MN |
NPI | 1275507386 |
---|---|
Provider Name | Dr. Paul J Amundson |
First Address | Minneapolis, MN 55425-4516 |
Second Address | Saint Louis Park, MN 55416-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F61167 | (02) | MN |