Doctor Name: | DR. ROY RAYMOND JUNTUNEN |
NPI Number: | 1326205352 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 11641 |
Business Practice Address: | 3723 Stebner Rd Hermantown, MN - 558111739 |
Business Phone Number: | 2187277104 |
Business Fax Number: | |
Mailing Address: | 3723 Stebner Rd, HERMANTOWN |
State: | MN |
Postal Code: | 558111739 |
Phone Number: | 2187277104 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2008 |
NPI Last Update Date: | 05/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 11641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |