Healthcare Provider Details

I. General information

NPI: 1154308088
Provider Name (Legal Business Name): PATRICIA SEGLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA WESTERBERG

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13060 ISLE DR
BAXTER MN
56425-8331
US

IV. Provider business mailing address

523 N 3RD ST
BRAINERD MN
56401-3054
US

V. Phone/Fax

Practice location:
  • Phone: 218-454-5935
  • Fax:
Mailing address:
  • Phone: 218-829-2861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43465
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: