| Midsota Plastic & Reconstructive Surgeons | |
|
3701 12th St N Suite 100 Saint Cloud MN 56303-2255 | |
| (320) 253-7257 | |
| (320) 257-5671 |
| Full Name | Midsota Plastic & Reconstructive Surgeons |
|---|---|
| Speciality | Clinic/Center |
| Location | 3701 12th St N, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Michael A Blair (SR VP & CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsota Plastic & Reconstructive Surgeons 1200 6th Ave N Saint Cloud MN 56303-2735 Ph: (320) 252-5131 | Midsota Plastic & Reconstructive Surgeons 3701 12th St N Suite 100 Saint Cloud MN 56303-2255 Ph: (320) 253-7257 |
| NPI Number | 1164978219 |
|---|---|
| Provider Enumeration Date | 08/29/2016 |
| Last Update Date | 11/19/2020 |
| Medicare PECOS PAC ID | 2466363395 |
|---|---|
| Medicare Enrollment ID | O20170811001936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164978219 | NPI | - | NPPES |
| 110890 | Other | MN | UCARE |
| 990228700 | Other | MN | MEDICAID |
| 35580 | Other | MN | HEALTH PARTNERS |
| 6D053CE | Other | MN | BLUE CROSS BLUE SHIELD |
| 98-04122 | Other | MN | MEDICA |
| N002912 | Other | MN | CHAMPUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Minnesota) | Primary |
Centracare - Coordinated Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 Phone: 320-255-7195 Fax: 320-200-3245 | |
St. Cloud State University Medical Clinic And Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 720 4th Ave S, Saint Cloud, MN 56301 Phone: 320-308-3193 Fax: 320-308-3192 | |
Centracare Health Community Paramedic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1406 6th Ave N, Saint Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-255-5711 | |
Memory Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2835 W Saint Germain St, Saint Cloud, MN 56301 Phone: 320-257-1777 Fax: 320-257-1776 | |
Center For Life Transitions Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38 24th Ave N, Saint Cloud, MN 56303 Phone: 320-746-0025 | |
Core Philosophy Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 25th Ave N Ste B1-114, Saint Cloud, MN 56303 Phone: 612-703-5479 |