Basic Information
Provider Information
NPI: 1003806381
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUISLER
FirstName: PAUL
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11995 SINGLETREE LN STE 500
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553445349
CountryCode: US
TelephoneNumber: 9525951301
FaxNumber: 6122944903
Practice Location
Address1: 11995 SINGLETREE LN STE 500
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553445349
CountryCode: US
TelephoneNumber: 9525951301
FaxNumber: 6122944903
Other Information
ProviderEnumerationDate: 10/26/2005
LastUpdateDate: 02/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD22502ORY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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