Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 49857 | MN |
NPI | 1003027087 |
---|---|
Provider Name | Kim R Schutterle |
First Address | Fairmont, MN 56031-4575 |
Second Address | Fairmont, MN 56031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/10/2020 |