Richard C Bosacker, MD | |
7455 Village Dr, Lino Lakes, MN 55014-1181 | |
(651) 717-3400 | |
Not Available |
Full Name | Richard C Bosacker |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 7455 Village Dr, Lino Lakes, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710938451 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 37951 (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 |
Mailing Address | Practice Location Address |
---|---|
Richard C Bosacker, MD 5200 Fairview Blvd, Wyoming, MN 55092-8013 Ph: () - | Richard C Bosacker, MD 7455 Village Dr, Lino Lakes, MN 55014-1181 Ph: (651) 717-3400 |
Tara Marie Cole, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7455 Village Dr, Lino Lakes, MN 55014 Phone: 651-717-3400 | |
Julie G Zimmerman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 576 Apollo Dr, Mail Stop 39603a, Lino Lakes, MN 55014 Phone: 651-784-1611 Fax: 651-784-6093 | |
Stephanie L J Bailey, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 576 Apollo Dr, Lino Lakes, MN 55014 Phone: 651-486-2320 Fax: 651-486-2321 | |
Steven H Slatten, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 576 Apollo Dr, Mail Stop 39603a, Lino Lakes, MN 55014 Phone: 651-784-1611 Fax: 651-784-6093 | |
Scott Moses, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7455 Village Dr, Lino Lakes, MN 55014 Phone: 651-717-3400 | |
Patrick Q Knoedler, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 576 Apollo Dr - Ms 39603a, North Suburban Family Physicians, Lino Lakes, MN 55014 Phone: 651-486-2320 Fax: 651-486-2321 | |
Loren Max Wilkes, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7455 Village Dr, Lino Lakes, MN 55014 Phone: 651-717-3400 |