Provider Demographics
NPI:1598770174
Name:SAUL, HERMAN JAMES JR (PA)
Entity Type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:JAMES
Last Name:SAUL
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 XERXES AVE S STE 116
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1200
Mailing Address - Country:US
Mailing Address - Phone:952-888-2024
Mailing Address - Fax:952-888-3985
Practice Address - Street 1:7901 XERXES AVE S STE 116
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1200
Practice Address - Country:US
Practice Address - Phone:952-888-2024
Practice Address - Fax:952-888-3985
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8973363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN291OtherNSAA CERTIFICATION
MN8973OtherSTATE REGISTRATION