Provider Demographics
NPI:1821132598
Name:LEY, CAROL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LEY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3M BUILDING # 220-6W-08
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55144-0001
Mailing Address - Country:US
Mailing Address - Phone:651-733-0694
Mailing Address - Fax:
Practice Address - Street 1:3M BUILDING # 220-6W-08
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55144-0001
Practice Address - Country:US
Practice Address - Phone:651-733-0694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN029371 02083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA93823Medicare UPIN