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General NPI Number Information
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NPI Number | 1134321789
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Entity Type | Individual
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Provider Name | MICHAEL JAMES PRIOLA DO
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Gender | Male
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 215 RADIO DRIVE SUITE 100
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 612-596-6100
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Fax | 612-339-7634
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Provider Business Mailing Address
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Address Line | 215 RADIO DRIVE SUITE 100
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 612-596-6100
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Fax | 612-339-7634
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20A9899
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 67028
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 0009898
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 59784
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License Number State | MN
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