| Dba Axis Medical Center | |
|
1 W Lake St Minneapolis MN 55408-3154 | |
| (612) 767-1557 | |
| Not Available |
| Full Name | Dba Axis Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 W Lake St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Zillehuma Ebrahim (CEO) |
| Authorized Official Contact | 6122827492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Axis Medical Center 1801 Nicollet Ave Minneapolis MN 55403-3791 Ph: (612) 823-2947 | Dba Axis Medical Center 1 W Lake St Minneapolis MN 55408-3154 Ph: (612) 767-1557 |
| NPI Number | 1538726393 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 09/16/2019 |
| Medicare PECOS PAC ID | 9032283262 |
|---|---|
| Medicare Enrollment ID | O20190919000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538726393 | NPI | - | NPPES |
| 1538726393 | Medicaid | MN |
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