| St. Croix Dermatology, Pa | |
|
1950 Curve Crest Blvd W Ste 100 Stillwater MN 55082-6062 | |
| (651) 275-0500 | |
| Not Available |
| Full Name | St. Croix Dermatology, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1950 Curve Crest Blvd W Ste 100, Stillwater, Minnesota |
| Authorized Official Name and Position | Christine Kay Markus (PRESIDENT) |
| Authorized Official Contact | 6512750500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Croix Dermatology, Pa 1950 Curve Crest Blvd W Ste 100 Stillwater MN 55082-6062 Ph: (651) 275-0500 | St. Croix Dermatology, Pa 1950 Curve Crest Blvd W Ste 100 Stillwater MN 55082-6062 Ph: (651) 275-0500 |
| NPI Number | 1215008362 |
|---|---|
| Provider Enumeration Date | 11/12/2006 |
| Last Update Date | 05/09/2008 |
| Medicare PECOS PAC ID | 9638210255 |
|---|---|
| Medicare Enrollment ID | O20100105000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215008362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1504 (Minnesota) | Primary |
| Provider Name | Christine K Markus |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982775029 PECOS PAC ID: 0345381968 Enrollment ID: I20120330000212 |
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