M Health Fairview Clinic - Forest Lake Isd 831 | |
400 Stinson Blvd Provider Enrollment Minneapolis MN 55413-2614 | |
(612) 672-2258 | |
(612) 672-6041 |
Full Name | M Health Fairview Clinic - Forest Lake Isd 831 |
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Speciality | Family Medicine |
Location | 400 Stinson Blvd, Minneapolis, Minnesota |
Authorized Official Name and Position | Robert Andrew Mccoy (VP REVENUE MANAGEMENT) |
Authorized Official Contact | 6126726594 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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M Health Fairview Clinic - Forest Lake Isd 831 6101 Scandia Trl N Room 411 Forest Lake MN 55025-2630 Ph: (651) 972-7900 | M Health Fairview Clinic - Forest Lake Isd 831 400 Stinson Blvd Provider Enrollment Minneapolis MN 55413-2614 Ph: (612) 672-2258 |
NPI Number | 1548718588 |
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Provider Enumeration Date | 09/20/2016 |
Last Update Date | 10/26/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548718588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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