| St Peter Street Internal Medicine | |
|
514 St Peter Street Suite 250 St Paul MN 55102 | |
| (651) 645-9600 | |
| (651) 645-9605 |
| Full Name | St Peter Street Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 514 St Peter Street, St Paul, Minnesota |
| Authorized Official Name and Position | Elisabeth A Slattery (DOCTOR/OWNER) |
| Authorized Official Contact | 6516459600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Peter Street Internal Medicine 6200 Shingle Creek Pkwy Suite 300 Brooklyn Center MN 55430-2128 Ph: (763) 561-5986 | St Peter Street Internal Medicine 514 St Peter Street Suite 250 St Paul MN 55102 Ph: (651) 645-9600 |
| NPI Number | 1174617146 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 07/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174617146 | NPI | - | NPPES |
| 10N38ST | Other | MN | BCBS |
| 0409583 | Other | MN | MEDICA |
| DF1694 | Other | MN | RAILROAD MEDICARE |
| 938088400 | Medicaid | MN | |
| 948448000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 31392 (Minnesota) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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