Provider Demographics
NPI:1215911466
Name:SARPAL, CAROL L (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:SARPAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12175 ABERDEEN ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4717
Mailing Address - Country:US
Mailing Address - Phone:763-785-4200
Mailing Address - Fax:763-785-3314
Practice Address - Street 1:12175 ABERDEEN ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4717
Practice Address - Country:US
Practice Address - Phone:763-785-4200
Practice Address - Fax:763-785-3314
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN36109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E72584Medicare UPIN