| |
4702 Grand Ave Duluth MN 55807-2742 | |
(218) 249-6800 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 4702 Grand Ave, Duluth, Minnesota |
Authorized Official Name and Position | Katherine Becker (VP COMPLIANCE) |
Authorized Official Contact | 2182495555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4702 Grand Ave Duluth MN 55807-2742 Ph: (218) 249-6800 | 4702 Grand Ave Duluth MN 55807-2742 Ph: (218) 249-6800 |
NPI Number | 1033161161 |
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Provider Enumeration Date | 05/17/2006 |
Last Update Date | 05/22/2024 |
Identifier | Type | State | Issuer |
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1033161161 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Lake Superior Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4602 Grand Ave Ste 1000, Duluth, MN 55807 Phone: 218-336-3520 Fax: 218-624-6097 | |
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