Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 58691 | MN |
NPI | 1013233840 |
---|---|
Provider Name | Mark Paul Suojanen |
First Address | Duluth, MN 55805-2107 |
Second Address | Duluth, MN 55805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 04/12/2020 |