Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL CHARLES LICK
Active Sole ProprietorMICHAEL CHARLES LICK is a Physician Assistant healthcare provider located in BLOOMINGTON, Minnesota. NPI 1023793932 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · BLOOMINGTON, MN
Registration Details
- NPI Number
- 1023793932
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 19, 2023 (3.1754619882137 yrs)
- Last Updated
- Jan 13, 2025
- Sole Proprietor
- Yes
Practice Information
- Address
-
4300 MARKET PTE DR STE 100BLOOMINGTON, MN, 554355435Browse MN providers · Browse ZIP 55435
- Phone
- 4574952767
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BLOOMINGTON, MN
| Name | Credential | NPI |
|---|---|---|
| DEBORAH R OSGOOD | PA-C | 1881698801 |
| MICHELLE HOPMAN | PA-C | 1023017084 |
| JILL MARIE ENGLUND | PAC | 1427042019 |
| TIMOTHY PAUL MCDONALD | PA C | 1194798900 |
| AMANDA J HARRISON | PAC | 1477528727 |
| MRS. MARY ANN HEFFELBOWER | PA-C | 1164483194 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.