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General NPI Number Information
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NPI Number | 1487730685
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Entity Type | Individual
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Provider Name | PHILIP A GASSELING MD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 2500 COMO AVENUE
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City | ST. PAUL
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State | MN
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Zip | 55108-1460
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Country | US
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Telephone | 952-853-8800
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Fax | 651-641-6205
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Provider Business Mailing Address
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Address Line | PO BOX 1309 MAIL STOP 21110Q 8170 33RD AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 952-853-8800
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Fax | 651-641-6205
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 12666
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 59384
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License Number State | MN
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