Michael Charles Lick

Physician Assistant · Bloomington, MN

Individual Active NPI

NPI number 1023793932

Practice location

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435
Phone
(457) 495-2767

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NPI record

NPI
1023793932
Entity type
Individual (Type 1)
Enumeration date
June 19, 2023
Last updated
January 13, 2025
Certified
January 13, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —

Mailing address

115 W 5TH St # 2
Duluth, MN 55806-2729
Phone
(612) 708-8024

About Michael Lick

Michael Charles Lick is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 4300 Market Pte Dr Ste 100, Bloomington, MN 55435-5435. The NPI number 1023793932 was assigned on June 19, 2023 and the record was last updated on January 13, 2025.

Frequently asked questions

What is the NPI number of Michael Charles Lick?

The NPI number is 1023793932.

What is the phone number of Michael Lick?

The phone number listed for the practice location is (457) 495-2767.

Where is Michael Lick located?

4300 Market Pte Dr Ste 100, Bloomington, MN 55435-5435.

What is the taxonomy code for Michael Lick?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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