Spencer, Paul J
Spencer, Paul J is an sole proprietor health care provider with primary practice located at 4465 White Bear Parkway , White Bear Lake MN 55110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Spencer, Paul J can be contacted via phone (651) 653-0062.Contact Information
Primary practice address
4465 White Bear Parkway
White Bear Lake MN 55110
Phone: (651) 653-0062
Fax: (651) 653-0288
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31236 | Minnesota |
Profile Details
| NPI number | 1376544650 |
|---|---|
| LBN Legal business name | Spencer, Paul J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Jul 21st, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376544650 | NPPES |
| Minnesota | MEDICAID | 282503100 |
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