Doctor Name: | MELISSA K SAMUELSSON |
NPI Number: | 1548273303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 401 Phalen Blvd Ms 41104c - Healthpartners Specialty Center 401 St. Paul, MN - 551305302 |
Business Phone Number: | 6512547900 |
Business Fax Number: | 6512547904 |
Mailing Address: | 8170 33rd Ave S, Ms21110q MINNEAPOLIS |
State: | MN |
Postal Code: | 554254516 |
Phone Number: | 9528835375 |
Fax Number: | 6512547904 |
NPI Enumeration Date: | 08/14/2006 |
NPI Last Update Date: | 01/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |