| Aalfa Family Clinic | |
|
4465 White Bear Pkwy White Bear Lake MN 55110-7626 | |
| (651) 653-0062 | |
| (651) 653-0288 |
| Full Name | Aalfa Family Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 4465 White Bear Pkwy, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Paul J Spencer (PRESIDENT) |
| Authorized Official Contact | 6516530062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aalfa Family Clinic 4465 White Bear Pkwy White Bear Lake MN 55110-7626 Ph: (651) 653-0062 | Aalfa Family Clinic 4465 White Bear Pkwy White Bear Lake MN 55110-7626 Ph: (651) 653-0062 |
| NPI Number | 1437150877 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810954146 |
|---|---|
| Medicare Enrollment ID | O20041217000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437150877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Minnesota) | Primary |
| 207R00000X | Internal Medicine | (Minnesota) | Primary |
| Provider Name | Matthew W Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386696870 PECOS PAC ID: 7810885613 Enrollment ID: I20040304000810 |
| Provider Name | Kathleen A Kobbermann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871605253 PECOS PAC ID: 0840287678 Enrollment ID: I20040426001098 |
| Provider Name | Mary M Paquette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598766875 PECOS PAC ID: 6305800509 Enrollment ID: I20041117000612 |
| Provider Name | Matthew J Paquette |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194726554 PECOS PAC ID: 0446291256 Enrollment ID: I20050520000875 |
| Provider Name | Patrick G Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407949530 PECOS PAC ID: 4789619347 Enrollment ID: I20051003000262 |
| Provider Name | Paul J Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376544650 PECOS PAC ID: 5799692513 Enrollment ID: I20100814000165 |
| Provider Name | Grace Carson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689169989 PECOS PAC ID: 2668722331 Enrollment ID: I20230420000934 |
| Provider Name | Elizabeth Nordin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356791271 PECOS PAC ID: 4587957691 Enrollment ID: I20230711001236 |
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