Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 54839 | MN |
NPI | 1013021914 |
---|---|
Provider Name | Glenn Matfin |
First Address | Minneapolis, MN 55416 |
Second Address | Minneapolis, MN 55416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 06/12/2012 |