Dr. Sam Andrew Miotke, M.D.
Surgery in Saint Paul, MN. Individual provider (NPI-1).
NPI number1972860880
StatusActive
Last updated in NPPESAug 4, 2020
Details
- NPI
- 1972860880
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sam Andrew Miotke
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 16, 2012
- Certification date
- Aug 4, 2020
- Last updated
- Aug 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 59198 | MN | Yes |
| 207T00000X | Neurological Surgery | 59198 | MN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
640 Jackson StSaint Paul, MN 55101-2502
Phone 651-254-1669
Mailing address
8170 33rd Ave SBloomington, MN 55425-4516
Phone 651-254-1669
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