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NPI Code Detail

MEDICARE: MAUREEN PAULY UTZ MD

MEDICARE: MAUREEN PAULY UTZ MD
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
1207N00000XDermatology Physician30857MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609851229
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN PAULY UTZ MD
Provider Business Mailing Address
First Line : 675 WATER ST
Second Line :
City : EXCELSIOR
State : MN
Zip : 55331-3072
Country : US
Telephone Number : 952-442-3188
Fax Number : 952-442-7861
Provider Business Practice Location Address
First Line : 675 WATER ST
Second Line :
City : EXCELSIOR
State : MN
Zip : 55331-3072
Country : US
Telephone Number : 952-442-3188
Fax Number : 952-442-7861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 12/17/2015

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Directions to “ MAUREEN PAULY UTZ MD” Practice Location

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