| Gregory Mark Dubla, RN,CRNA | |
| 
					400 East 3rd Street, Duluth, MN 55805  | |
| (218) 783-8364 | |
| Not Available | 
| Full Name | Gregory Mark Dubla | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 400 East 3rd Street, Duluth, Minnesota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730171588 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 108993 (Wisconsin) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | R1005525 (Minnesota) | Primary | 
| Entity Name | Southdale Anesthesiologists Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1154381804 PECOS PAC ID: 6709842461 Enrollment ID: O20041203000743  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Gregory Mark Dubla, RN,CRNA 400 East 3rd Street, Essentia Health Duluth Clinic, Duluth, MN 55805 Ph: (218) 783-8364  | Gregory Mark Dubla, RN,CRNA 400 East 3rd Street, Duluth, MN 55805 Ph: (218) 783-8364  | 
Christian Conner, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-4150  | |
Scott Ian Halvorson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5555  | |
Jennifer M Heitzman, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364  | |
Emily Kathryn Eash, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5352 Fax: 218-249-5534  | |
Julie Kay Hendricks, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth Clinic, Duluth, MN 55805 Phone: 218-786-8364  | |
Jesse Stokke, APRN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5352 Fax: 218-249-5534  | |
Luke Andrew Schumacher, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5352 Fax: 218-249-5534  |