Male or Other

Paul W. Nerothin MD

Family Medicine Physician in Forest Lake, MN(View on Map)

Full Name

Paul W Nerothin MD

NPI Number

1861454084

NPI Type

Individual Provider

Gender

Male

Enumeration Date

04/04/2006

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

20298

Contact
Information

Purpose

Mailing
Location

Address

2925 CHICAGO AVE
1540 LAKE ST S

City

Minneapolis
Forest Lake

State

MN
MN

Postal Code

55407-1321
55025-2628

Country

US
US

Telephone Number

(612) 262-5000
(651) 464-7100

Identifiers

Identifier

606773500

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/10/2011

Provider Address

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