Provider Demographics
NPI:1770559643
Name:MUA, MAY (PA)
Entity type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:MUA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:8170 33RD AVENUE SOUTH
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-7820
Mailing Address - Fax:651-254-7827
Practice Address - Street 1:401 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130
Practice Address - Country:US
Practice Address - Phone:651-254-7820
Practice Address - Fax:651-254-7827
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2018-10-30
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Provider Licenses
StateLicense IDTaxonomies
MN9664363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN146309800Medicaid
MN146309800Medicaid