Doctor Name: | DR. SAMANTHA KAE PULLEN |
NPI Number: | 1609017714 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 51627 |
Business Practice Address: | 800 E 28th St Minneapolis, MN - 554073723 |
Business Phone Number: | 6128636766 |
Business Fax Number: | |
Mailing Address: | 800 E 28th St, MINNEAPOLIS |
State: | MN |
Postal Code: | 554073723 |
Phone Number: | 6128636766 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2009 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 51627 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |