Provider Demographics
NPI:1114083235
Name:LO, FOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:FOUNG
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2680 SNELLING AVE N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1876
Mailing Address - Country:US
Mailing Address - Phone:651-326-1600
Mailing Address - Fax:651-326-1565
Practice Address - Street 1:2680 SNELLING AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1876
Practice Address - Country:US
Practice Address - Phone:651-326-1600
Practice Address - Fax:651-326-1565
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN42329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine