| John William Cheesebro, DPM | |
|
2805 Campus Dr Ste 225, Plymouth, MN 55441-2678 | |
| (612) 788-8778 | |
| (612) 869-3473 |
| Full Name | John William Cheesebro |
|---|---|
| Gender | Male |
| Speciality | Podiatrist |
| Location | 2805 Campus Dr Ste 225, Plymouth, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144333667 | NPI | - | NPPES |
| 0541840001 | Other | MN | ADMINISTAR DEFENSE ID |
| 323225500 | Medicaid | MN | |
| 271055 | Other | MN | MEDICA PROVIDER ID |
| HP13053 | Other | MN | HEALTHPARTNERS PROVIDER # |
| 11691MI | Other | MI | BC/BS PROVIDER ID |
| 411695192 | Other | MN | FEDERAL TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 366 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| John William Cheesebro, DPM 6625 Lyndale Ave S Ste 300, Richfield, MN 55423-2491 Ph: (612) 788-8778 | John William Cheesebro, DPM 2805 Campus Dr Ste 225, Plymouth, MN 55441-2678 Ph: (612) 788-8778 |
Affiliated Foot And Ankle Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2805 Campus Dr Ste 225, Plymouth, MN 55441 Phone: 763-383-8808 Fax: 763-383-6033 | |
Mark E Zelent, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2805 Campus Dr, Suite #345, Plymouth, MN 55441 Phone: 763-520-2980 Fax: 763-520-2991 | |
Robert Mullin, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2805 Campus Dr, Suite 325, Plymouth, MN 55441 Phone: 763-550-1013 Fax: 763-550-0615 |