Provider Demographics
NPI:1952367633
Name:OBERSTAR, JOEL V (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:V
Last Name:OBERSTAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:SUITE F256-2B WEST
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:612-273-8700
Mailing Address - Fax:612-273-9779
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:SUITE F256-2B WEST
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-273-8700
Practice Address - Fax:612-273-9779
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2007-12-10
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Provider Licenses
StateLicense IDTaxonomies
MN462692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNI00441Medicare UPIN