Provider Demographics
NPI:1275024663
Name:MOHR, MARY CATHERINE (DO)
Entity Type:Individual
Prefix:
First Name:MARY CATHERINE
Middle Name:
Last Name:MOHR
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2025 SLOAN PL STE 35
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2092
Mailing Address - Country:US
Mailing Address - Phone:651-772-1572
Mailing Address - Fax:651-772-1889
Practice Address - Street 1:4786 BANNING AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3264
Practice Address - Country:US
Practice Address - Phone:651-426-6402
Practice Address - Fax:651-429-3402
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2021-10-18
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Provider Licenses
StateLicense IDTaxonomies
MN70152207Q00000X
IAR-11163207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine