Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 43757 | MN |
N | 111NI0900X | Internist | 43757 | MN |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 43757 | MN |
Y | 207RC0000X | Internist - Cardiovascular Disease | 43757 | MN |
NPI | 1750340485 |
---|---|
Provider Name | Jamie Michael Pelzel |
First Address | Saint Cloud, MN 56303-2735 |
Second Address | Saint Cloud, MN 56303-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 09/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
397172400 | (05) | MN |
H83394 | (02) |