| Dermatology Professionals Pa | |
|
1511 Northway Dr Ste 103 Saint Cloud MN 56303-1262 | |
| (218) 454-7546 | |
| (218) 454-0390 |
| Full Name | Dermatology Professionals Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 1511 Northway Dr Ste 103, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Morgan Leigh Burgstaler (ADMINISTRATOR) |
| Authorized Official Contact | 2184547546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dermatology Professionals Pa 13359 Isle Dr Ste 3 Baxter MN 56425-2223 Ph: (218) 454-7546 | Dermatology Professionals Pa 1511 Northway Dr Ste 103 Saint Cloud MN 56303-1262 Ph: (218) 454-7546 |
| NPI Number | 1720840788 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 01/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720840788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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