Provider Demographics
NPI:1225352180
Name:PARE, WES
Entity Type:Individual
Prefix:MR
First Name:WES
Middle Name:
Last Name:PARE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20679 STATE HIGHWAY 108
Mailing Address - Street 2:
Mailing Address - City:PELICAN RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56572-7425
Mailing Address - Country:US
Mailing Address - Phone:218-863-7625
Mailing Address - Fax:
Practice Address - Street 1:20679 STATE HIGHWAY 108
Practice Address - Street 2:
Practice Address - City:PELICAN RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56572-7425
Practice Address - Country:US
Practice Address - Phone:218-863-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN49-89552OtherMEDICA