| Dr David William Groth, MD | |
|
6425 Nicollet Ave, Suite # 202, Richfield, MN 55423-1675 | |
| (612) 869-2086 | |
| (612) 869-4903 |
| Full Name | Dr David William Groth |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 42 Years |
| Location | 6425 Nicollet Ave, Richfield, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629000534 | NPI | - | NPPES |
| 0492002 | Other | MN | PREFERRED ONE |
| 722390100 | Medicaid | MN | |
| 09Q99GR | Other | MN | BCBS |
| 03-00033 | Other | MN | MEDICA CHOICE & PRIMARY |
| 100187 | Other | MN | UCARE |
| HP13424 | Other | MN | HEALTHPARTNERS |
| 20931 | Other | MN | ARAZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 29749 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| United Skin Specialists Ltd | 0446558993 | 14 |
| Entity Name | Fairview Express Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Entity Name | United Skin Specialists Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861861759 PECOS PAC ID: 0446558993 Enrollment ID: O20160415001552 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David William Groth, MD 6425 Nicollet Ave, Suite # 202, Richfield, MN 55423-1675 Ph: (612) 869-2086 | Dr David William Groth, MD 6425 Nicollet Ave, Suite # 202, Richfield, MN 55423-1675 Ph: (612) 869-2086 |
Elliot Daniel Backer, PA-C Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6425 Nicollet Ave Ste 202, Richfield, MN 55423 Phone: 612-869-2086 | |
Dr. Susan M Holt, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6425 Nicollet Ave, Suite 202, Richfield, MN 55423 Phone: 612-869-2086 Fax: 612-869-4903 |