Provider Demographics
NPI:1134321789
Name:PRIOLA, MICHAEL JAMES (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:PRIOLA
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:215 RADIO DRIVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:612-596-6100
Mailing Address - Fax:612-339-7634
Practice Address - Street 1:215 RADIO DRIVE SUITE 100
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:612-596-6100
Practice Address - Fax:612-339-7634
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2020-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9899207X00000X
GA67028207XP3100X
OH0009898207XP3100X
MN59784207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery