Mutnick, Jack Leon-Max

Mutnick, Jack Leon-Max is an individual health care provider with primary practice located at 4201 Excelsior Blvd , St Louis Park MN 55416-4728. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Mutnick, Jack Leon-Max can be contacted via phone (952) 933-8900.

Contact Information

Primary practice address
4201 Excelsior Blvd St Louis Park MN 55416-4728
Phone: (952) 933-8900
Fax: (952) 945-9536
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 48180 Minnesota
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 48180 Minnesota

Profile Details

NPI number 1487601316
LBN Legal business name Mutnick, Jack Leon-Max
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Feb 20th, 2023 - about 2 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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