| Proactive Healthcare | |
|
101 5th St E Suite 227 Saint Paul MN 55101-1898 | |
| (651) 778-0080 | |
| (651) 778-0195 |
| Full Name | Proactive Healthcare |
|---|---|
| Speciality | General Practice |
| Location | 101 5th St E, Saint Paul, Minnesota |
| Authorized Official Name and Position | Nathan Burdash (C.E.O.) |
| Authorized Official Contact | 6517780080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Healthcare 101 5th St E Suite 227 Saint Paul MN 55101-1898 Ph: (651) 778-0080 | Proactive Healthcare 101 5th St E Suite 227 Saint Paul MN 55101-1898 Ph: (651) 778-0080 |
| NPI Number | 1891058384 |
|---|---|
| Provider Enumeration Date | 06/19/2012 |
| Last Update Date | 09/27/2012 |
| Medicare PECOS PAC ID | 0143477521 |
|---|---|
| Medicare Enrollment ID | O20120821000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891058384 | NPI | - | NPPES |
| 1891058384 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 41988 (Minnesota) | Primary |
| Provider Name | Nathan M Burdash |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861553588 PECOS PAC ID: 9638247364 Enrollment ID: I20081008000644 |
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