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General NPI Number Information
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NPI Number | 1982297065
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Entity Type | Organization
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Legal Business Name | DOXA HEALTHCARE LLC
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 01/29/2022
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Provider Practice Location Address
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Address Line | 1001 JOHNSON PKWY STE A1
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City | SAINT PAUL
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State | MN
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Zip | 55106-3655
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Country | US
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Telephone | 651-888-8306
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Fax | 651-447-5369
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Provider Business Mailing Address
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Address Line | 1901 DIETER ST
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City | SAINT PAUL
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State | MN
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Zip | 55109-4413
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Country | US
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Telephone | 651-888-8306
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAMON NOLA
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Credential | MD
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Telephone | 316-208-1871
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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 |
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License Number State |
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