| Dermatology Professionals PA | |
|
15167 Edgewood Dr Suite 200 Baxter MN 56401-6946 | |
| (218) 454-7546 | |
| Not Available |
| Full Name | Dermatology Professionals PA |
|---|---|
| Speciality | Clinic/center |
| Location | 15167 Edgewood Dr, Baxter, Minnesota |
| Authorized Official Name and Position | Morgan Burgstaler (ADMINISTRATOR) |
| Authorized Official Contact | 2184543065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dermatology Professionals PA 13359 Isle Dr Suite 3 Baxter MN 56425-2222 | Dermatology Professionals PA 15167 Edgewood Dr Suite 200 Baxter MN 56401-6946 Ph: (218) 454-7546 |
| NPI Number | 1306196548 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306196548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 45453 (Minnesota) | Primary |
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