Provider Demographics
NPI:1538141908
Name:SPINNER, PAUL A (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:SPINNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12800 ROLLING RIDGE RD
Mailing Address - Street 2:CENTRACARE CLINIC
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-8838
Mailing Address - Country:US
Mailing Address - Phone:763-261-7000
Mailing Address - Fax:763-261-7004
Practice Address - Street 1:12800 ROLLING RIDGE RD
Practice Address - Street 2:CENTRACARE CLINIC
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308-8838
Practice Address - Country:US
Practice Address - Phone:763-261-7000
Practice Address - Fax:763-261-7004
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-12-13
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Provider Licenses
StateLicense IDTaxonomies
MN41730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
121596OtherU CARE
846385OtherARAZ GROUP
2116687OtherFIRST HEALTH PLAN
HP28636OtherHEALTH PARTNERS
86D78SPOtherBLUE CROSS BLUE SHIELD
0115819OtherMEDICA HEALTH PLANS
1019892OtherPREFERRED ONE
433517100OtherMEDICAL ASSISTANCE
121596OtherU CARE