Antonio Michael Guimaraes, | |
425 7th St Nw, Cass Lake, MN 56633-3360 | |
(218) 335-3200 | |
(218) 335-3227 |
Full Name | Antonio Michael Guimaraes |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 425 7th St Nw, Cass Lake, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679529366 | NPI | - | NPPES |
960520700 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 39051 (Minnesota) | Primary |
Entity Name | Department Of Health & Human Services Phs Ihs |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194754382 PECOS PAC ID: 7517879794 Enrollment ID: O20031105000353 |
Mailing Address | Practice Location Address |
---|---|
Antonio Michael Guimaraes, 425 7th St Nw, Cass Lake, MN 56633-3360 Ph: (218) 335-3200 | Antonio Michael Guimaraes, 425 7th St Nw, Cass Lake, MN 56633-3360 Ph: (218) 335-3200 |
Anoshirvan Mazhari, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 425 7th St Nw, Cass Lake, MN 56633 Phone: 218-335-3200 | |
Dr. Adrian A. Cordovi, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 425 7th St Nw, Cass Lake, MN 56633 Phone: 218-335-3200 Fax: 218-335-3227 | |
Roleen Ruth Walgenbach, RNP Family Medicine Medicare: Medicare Enrolled Practice Location: 425 7th St Nw, Cass Lake, MN 56633 Phone: 218-335-3200 | |
Gilbert W Mouser, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 219 Grant Utley Ave, Cass Lake, MN 56633 Phone: 218-335-2559 Fax: 218-335-2755 | |
Gregory L Roberts, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 219 Grant Utely Ave Nw, Cass Lake, MN 56633 Phone: 218-335-2559 | |
Dr. Dawn Lucile Wyllie, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 425 7th St Nw, Cass Lake, MN 56633 Phone: 218-335-3200 Fax: 218-335-3204 |