| Accord Health | |
|
11230 86th Ave N Maple Grove MN 55369-4510 | |
| (651) 955-6747 | |
| Not Available |
| Full Name | Accord Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 11230 86th Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Vamsi Dwaram (MANAGER) |
| Authorized Official Contact | 6519556747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Accord Health 11230 86th Ave N Maple Grove MN 55369-4510 Ph: () - | Accord Health 11230 86th Ave N Maple Grove MN 55369-4510 Ph: (651) 955-6747 |
| NPI Number | 1679211296 |
|---|---|
| Provider Enumeration Date | 05/24/2022 |
| Last Update Date | 05/25/2022 |
| Certification Date | 05/25/2022 |
| Medicare PECOS PAC ID | 9133577158 |
|---|---|
| Medicare Enrollment ID | O20231130002095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679211296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chinwe C Eke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689858557 PECOS PAC ID: 5395099386 Enrollment ID: I20181109001384 |
| Provider Name | Titilayo Omonisa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497307458 PECOS PAC ID: 2163754342 Enrollment ID: I20191022001111 |
| Provider Name | Sarojanie Devi Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962110205 PECOS PAC ID: 0143679738 Enrollment ID: I20231207002589 |
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