Duthoy, Dale J

Duthoy, Dale J is an individual health care provider with primary practice located at 4786 Banning Ave , White Bear Lake MN 55110-3264. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Duthoy, Dale J can be contacted via phone (651) 426-6402.

Contact Information

Primary practice address
4786 Banning Ave White Bear Lake MN 55110-3264
Fax: (651) 429-3402
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27120 Minnesota

Profile Details

NPI number 1215942180
LBN Legal business name Duthoy, Dale J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2006
Last updated Oct 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215942180 NPPES
Minnesota MEDICAID 645567100

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