Mohr, Bryan

Mohr, Bryan is an individual health care provider with primary practice located at 6625 Lyndale Ave S Ste 105 , Richfield MN 55423-2673. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Mohr, Bryan can be contacted via phone (612) 788-8778.

Contact Information

Primary practice address
6625 Lyndale Ave S Ste 105 Richfield MN 55423-2673
Phone: (612) 788-8778
Fax: (612) 869-3473
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1164-25 Wisconsin
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 631 Minnesota

Profile Details

NPI number 1043215528
LBN Legal business name Mohr, Bryan
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Apr 29th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043215528 NPPES
Minnesota Other 54B22MO BLUE CROSS
Minnesota Other HP30542 BLUE CROSS
Minnesota Other 124307 BLUE CROSS
Minnesota MEDICAID 148473700 BLUE CROSS

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