Basic Information
| Provider Information | |||||||||
| NPI: | 1710933486 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 393 DUNLAP ST N | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551044200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513121500 | ||||||||
| FaxNumber: | 6513121595 | ||||||||
| Practice Location | |||||||||
| Address1: | 2805 CAMPUS DR | ||||||||
| Address2: | SUITE 405 | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554412676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513121717 | ||||||||
| FaxNumber: | 7633831932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KARULF | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT / CEO | ||||||||
| AuthorizedOfficialTelephone: | 6513121500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.