is a General Practice in Minneapolis, Minnesota. practices all healthcare services and medical treatments related to General Practice. The NPI Number for is 1235396037. The last update date is .
's current location address is 2707 Nicollet Ave, Minneapolis, Minnesota. You can contact this provider via phone number 6128748811 and fax number 6128740020. The mailing address for is 2707 Nicollet Ave, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2707 Nicollet Ave, Minneapolis, Minnesota |
| Phone Number | 6128748811 |
| Fax Number | 6128740020 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1235396037 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2707 Nicollet Ave |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 55408 |
| Phone Number | 6128748811 |
| Fax Number | 6128740020 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | 25230 |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 212067400 | MN | -- |
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