Lisa Grundtner, MD | |
6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 | |
(952) 993-5000 | |
Not Available |
Full Name | Lisa Grundtner |
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Gender | Female |
Speciality | Hospitalist |
Location | 6500 Excelsior Blvd, Saint Louis Park, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730744699 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 71055 (Minnesota) | Secondary |
208M00000X | Hospitalist | 71055 (Minnesota) | Primary |
Entity Name | Park Nicollet Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
Entity Name | Hutchinson Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053508820 PECOS PAC ID: 0345330072 Enrollment ID: O20080312000695 |
Mailing Address | Practice Location Address |
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Lisa Grundtner, MD 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () - | Lisa Grundtner, MD 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 Ph: (952) 993-5000 |
Cristina Baker, MD Hospitalist Medicare: Not Enrolled in Medicare Practice Location: 3800 Park Nicollet Blvd, Saint Louis Park, MN 55416 Phone: 952-993-3123 Fax: 952-993-3286 | |
Gurpal S Benning, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 3850 Park Nicollet Blvd, Saint Louis Park, MN 55416 Phone: 952-993-3400 Fax: 985-875-2780 |