Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 30805 | MN |
NPI | 1548376221 |
---|---|
Provider Name | Paul J Donahue |
First Address | Woodbury, MN 55125-4925 |
Second Address | Saint Paul, MN 55102-2463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 25/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253087200 | (05) | MN |
B58554 | (02) | |
P00355792 | RAILROAD MEDICARE (01) | MN |