Provider Demographics
NPI:1285743781
Name:GEORGE, PIERRE MICHEL (MD)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:MICHEL
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:60 PLATO BLVD E
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1827
Mailing Address - Country:US
Mailing Address - Phone:651-209-1600
Mailing Address - Fax:651-291-9169
Practice Address - Street 1:280 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104
Practice Address - Country:US
Practice Address - Phone:651-645-3628
Practice Address - Fax:651-645-3620
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN35668207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN445882600Medicaid
MN445882600Medicaid