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General NPI Number Information
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NPI Number | 1114989068
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Entity Type | Individual
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Provider Name | STANLEY A WOOLNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 651 ARCADE ST
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City | SAINT PAUL
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State | MN
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Zip | 55106-4518
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Country | US
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Telephone | 651-793-3100
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Fax | 651-793-3133
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Provider Business Mailing Address
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Address Line | 651 ARCADE ST
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City | SAINT PAUL
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State | MN
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Zip | 55106-4518
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Country | US
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Telephone | 651-793-3100
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Fax | 651-793-3133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34999
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License Number State | MN
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