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NPI Code Detail

MEDICARE: PAUL RUSSELL GIDDINGS MSW, LGSW

MEDICARE: PAUL RUSSELL GIDDINGS MSW, LGSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker25814MN

General Provider Information

NPI Number : 1033751003
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL RUSSELL GIDDINGS MSW, LGSW
Provider Business Mailing Address
First Line : 332 W SUPERIOR ST STE 300
Second Line :
City : DULUTH
State : MN
Zip : 55802-1844
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 332 W SUPERIOR ST STE 300
Second Line :
City : DULUTH
State : MN
Zip : 55802-1844
Country : US
Telephone Number : 437-921-8722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2019
Last Update Date : 02/09/2026

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