| Partners in Pediatrics | |
|
12720 Bass Lake Rd Maple Grove MN 55369-6307 | |
| (763) 559-2861 | |
| (763) 559-1338 |
| Full Name | Partners in Pediatrics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 12720 Bass Lake Rd, Maple Grove, Minnesota |
| Authorized Official Name and Position | Brenda Lu Alexander Mccormick (SR. VP AND CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6128136129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Partners in Pediatrics 5901 Lincoln Drive Cbc-2-rev/pe Edina MN 55436-1611 Ph: (952) 992-5691 | Partners in Pediatrics 12720 Bass Lake Rd Maple Grove MN 55369-6307 Ph: (763) 559-2861 |
| NPI Number | 1013278720 |
|---|---|
| Provider Enumeration Date | 05/30/2012 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013278720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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