Provider Demographics
NPI:1568405488
Name:FINSTAD, PAUL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:FINSTAD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:4040 COON RAPIDS BLVD NW
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2522
Mailing Address - Country:US
Mailing Address - Phone:763-427-9980
Mailing Address - Fax:763-427-9908
Practice Address - Street 1:4040 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 120
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55433-2522
Practice Address - Country:US
Practice Address - Phone:763-427-9980
Practice Address - Fax:763-427-9908
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9261363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN156675000Medicaid
MN970001299Medicare ID - Type Unspecified
MNS80148Medicare UPIN