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General NPI Number Information
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NPI Number | 1437132578
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Entity Type | Individual
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Provider Name | PAUL R REMARK LCP
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 330 N 8TH AVE E
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City | DULUTH
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State | MN
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Zip | 55805-2024
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Country | US
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Telephone | 218-723-1112
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Fax | 218-529-9120
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Provider Business Mailing Address
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Address Line | 4855 WEST ARROWHEAD ROAD ESSENTIA HEALTH HERMANTOWN CLINIC
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City | HERMANTOWN
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State | MN
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Zip | 55811-3936
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Country | US
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Telephone | 218-786-3540
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP0247
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License Number State | MN
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