| Paul Richard Anderson, | |
|
400 E 3rd St, Duluth, MN 55805-1951 | |
| (218) 786-4150 | |
| Not Available |
| Full Name | Paul Richard Anderson |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 400 E 3rd St, 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 |
|---|---|---|---|
| 1487717047 | NPI | - | NPPES |
| 165500100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 25596 (Minnesota) | Primary |
| Entity Name | The Duluth Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245278209 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000120 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Richard Anderson, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-4150 | Paul Richard Anderson, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-4150 |
Mark Paul Suojanen, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5352 Fax: 218-249-5534 | |
Dr. Donald L Leake, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5353 | |
Kenneth Walter Niejadlik, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-4150 | |
Jason Scott Johnson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5555 | |
Mirko Krolo, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5352 Fax: 218-249-5534 | |
Dr. George J. Schaenzer, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5353 | |
Dr. Dane Mcgee Ingebrigtson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 |