Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R1210572 | MN |
NPI | 1386805067 |
---|---|
Provider Name | Steven Andrew Mcdonald |
First Address | Minneapolis, MN 55455-0341 |
Second Address | Minneapolis, MN 55455-0341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 24/06/2008 |