| Midwest Trauma Center | |
|
7400 Metro Blvd Ste 413 Edina MN 55439-2326 | |
| (218) 310-2864 | |
| Not Available |
| Full Name | Midwest Trauma Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7400 Metro Blvd Ste 413, Edina, Minnesota |
| Authorized Official Name and Position | Loralee Ann Carter (OWNER) |
| Authorized Official Contact | 2183102864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Trauma Center 7400 Metro Blvd Ste 413 Edina MN 55439-2326 Ph: (218) 310-2864 | Midwest Trauma Center 7400 Metro Blvd Ste 413 Edina MN 55439-2326 Ph: (218) 310-2864 |
| NPI Number | 1356530224 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 05/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356530224 | NPI | - | NPPES |
| 77B26CA | Other | MN | BLUE CROSS BLUE SHIELD |
| 62-64099 | Other | MN | UNITED BEHAVIORAL HEALTH |
| 858247500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 15212 (Minnesota) | Primary |
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