Healthcare Provider Details

I. General information

NPI: 1336247956
Provider Name (Legal Business Name): PAUL A SATTERLEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-5609
  • Fax: 763-520-7562
Mailing address:
  • Phone: 763-520-5609
  • Fax: 763-520-7562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number41070
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: