Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 70008 | MN |
NPI | 1073968376 |
---|---|
Provider Name | Dr. Stephen Mchale |
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 | 25/04/2016 |
Last Update Date | 28/10/2021 |