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347 Smith Ave N Ste 203 St Paul MN 55102-2388 | |
(651) 241-7733 | |
(651) 241-7798 |
Full Name | |
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Speciality | Internal Medicine |
Location | 347 Smith Ave N, St Paul, Minnesota |
Authorized Official Name and Position | Dominica Tallarico (COO) |
Authorized Official Contact | 6122222222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 43 Mail Route 10585 Minneapolis MN 55440-0043 Ph: (612) 262-1166 | 347 Smith Ave N Ste 203 St Paul MN 55102-2388 Ph: (651) 241-7733 |
NPI Number | 1376849729 |
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Provider Enumeration Date | 02/02/2011 |
Last Update Date | 01/22/2025 |
Identifier | Type | State | Issuer |
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1376849729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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