Keith Matthew Wirth, | |
2945 Hazelwood St Ste 200, Maplewood, MN 55109-1243 | |
(612) 232-7800 | |
Not Available |
Full Name | Keith Matthew Wirth |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 2945 Hazelwood St Ste 200, Maplewood, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336568617 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 61495 (Minnesota) | Primary |
Entity Name | Fairview Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
Entity Name | Fairview Clinics |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
Entity Name | Healtheast Medical Research Institute |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507 |
Entity Name | Fairview Express Care |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
Mailing Address | Practice Location Address |
---|---|
Keith Matthew Wirth, 2945 Hazelwood St Ste 200, Maplewood, MN 55109-1243 Ph: (612) 232-7800 | Keith Matthew Wirth, 2945 Hazelwood St Ste 200, Maplewood, MN 55109-1243 Ph: (612) 232-7800 |
Dr. Peter B Wilton, MD Surgery Medicare: Medicare Enrolled Practice Location: 1655 Beam Ave Ste 302, Maplewood, MN 55109 Phone: 651-227-6351 | |
John G Shearen, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1997 Sloan Pl, Suite 17, Maplewood, MN 55117 Phone: 715-531-6800 Fax: 715-531-6801 | |
Roy Ea Hope, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1973 Sloan Pl, #225, Maplewood, MN 55117 Phone: 651-224-1347 Fax: 651-855-0126 | |
Geoffrey S. Fasen, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2945 Hazelwood St Ste 100, Maplewood, MN 55109 Phone: 651-227-6351 Fax: 651-227-1134 | |
Ryan Christopher Knoper, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2945 Hazelwood St Ste 100, Maplewood, MN 55109 Phone: 651-227-6351 | |
Dr. James M. Mcgreevy, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1655 Beam Ave, Suite 302, Maplewood, MN 55109 Phone: 651-227-6351 Fax: 651-227-1134 |