Healthcare Provider Details

I. General information

NPI: 1265724124
Provider Name (Legal Business Name): KAREGA Y PAISLEY M.D.M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WABASHA ST S
SAINT PAUL MN
55107-1805
US

IV. Provider business mailing address

205 WABASHA ST S
SAINT PAUL MN
55107-1805
US

V. Phone/Fax

Practice location:
  • Phone: 651-293-8269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberNA
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number23753
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: