| Cpmg-andover Park Clinic | |
|
13819 Hanson Blvd Nw Andover MN 55304-7608 | |
| (763) 572-5710 | |
| (763) 862-4415 |
| Full Name | Cpmg-andover Park Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13819 Hanson Blvd Nw, Andover, Minnesota |
| Authorized Official Name and Position | Joen V Condon (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7635865839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cpmg-andover Park Clinic 6401 University Ave Ne Fridley MN 55432-4341 Ph: (763) 572-5710 | Cpmg-andover Park Clinic 13819 Hanson Blvd Nw Andover MN 55304-7608 Ph: (763) 572-5710 |
| NPI Number | 1639274160 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639274160 | NPI | - | NPPES |
| 02071BR | Other | MN | BCBS |
| CT1003 | Other | MN | MEDICARE RAILROAD |
| UC0003 | Other | MN | UCARE URGENT CARE |
| 54814 | Other | MN | HEALTHPARTNERS |
| 122190 | Other | MN | UCARE MN |
| 98-66092 | Other | MN | MEDICA URGENT CARE |
| 98-00470 | Other | MN | MEDICA NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Minnesota) | Primary |
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