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NPI Code Detail

MEDICARE: MR. DEAN ALAN STULZ PA

MEDICARE: MR. DEAN ALAN STULZ PA
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
1363A00000XPhysician AssistantPA04471TX
2363A00000XPhysician Assistant10395MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131T18INOTHERMNBCBS
2169318P539OTHERMNUCARE
331T18INOTHERMNCCS
41219767OTHERMNARAZ
59823046OTHERMNMEDICA

General Provider Information

NPI Number : 1639275605
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEAN ALAN STULZ PA
Provider Business Mailing Address
First Line : P.O. BOX 296
Second Line :
City : SARTELL
State : MN
Zip : 56377-1977
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Provider Business Practice Location Address
First Line : 100 SOUTH 2ND STREET
Second Line :
City : SARTELL
State : MN
Zip : 56377-1977
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 04/06/2017

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1457452666 — DR. MATTHEW G. ROSSITER D.C.
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Directions to “ MR. DEAN ALAN STULZ PA” Practice Location

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