| Cpmg-blaine Clinic | |
|
10961 Club West Pkwy Blaine MN 55449-4671 | |
| (763) 572-5710 | |
| (763) 528-2945 |
| Full Name | Cpmg-blaine Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 10961 Club West Pkwy, Blaine, Minnesota |
| Authorized Official Name and Position | Joen V Condon (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7635865839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cpmg-blaine Clinic 6401 University Ave Ne Fridley MN 55432-4341 Ph: (763) 572-5710 | Cpmg-blaine Clinic 10961 Club West Pkwy Blaine MN 55449-4671 Ph: (763) 572-5710 |
| NPI Number | 1386749851 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386749851 | NPI | - | NPPES |
| 02071BR | Other | MN | BCBS OF MN |
| UC0035 | Other | MN | UCARE URGENT CARE |
| 181992 | Other | MN | UCARE CLINIC NUMBER |
| CT1003 | Other | MN | MEDICARE RAILROAD |
| AQ909 | Other | MN | PREFERRED ONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Minnesota) | Primary |
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