Provider Demographics
NPI:1639275605
Name:STULZ, DEAN ALAN (PA)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ALAN
Last Name:STULZ
Suffix:
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:P.O. BOX 296
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-1977
Mailing Address - Country:US
Mailing Address - Phone:320-251-2600
Mailing Address - Fax:320-251-4763
Practice Address - Street 1:100 SOUTH 2ND STREET
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-1977
Practice Address - Country:US
Practice Address - Phone:320-251-2600
Practice Address - Fax:320-251-4763
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04471363A00000X
MN10395363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN31T18INOtherBCBS
MN169318P539OtherUCARE
MN31T18INOtherCCS
MN1219767OtherARAZ
MN9823046OtherMEDICA
MN31T18INOtherCCS