Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 19546 | MN |
NPI | 1063650307 |
---|---|
Provider Name | Dr. Peter Paul Frohnert |
First Address | Saint Paul, MN 55101-4700 |
Second Address | Saint Paul, MN 55101-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2009 |
Last Update Date | 24/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19546 | MINNESOTA BOARD OF MEDICAL PRACTICE (01) | MN |