| Digestive Endoscopy, Pa | |
|
17322 91st Ave N Maple Grove MN 55311-5403 | |
| (763) 416-0399 | |
| (763) 416-0399 |
| Full Name | Digestive Endoscopy, Pa |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 17322 91st Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | William Charles Duane (PRESIDENT) |
| Authorized Official Contact | 7634160399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Endoscopy, Pa 5970 Arbour Ave Edina MN 55436-2521 Ph: (952) 920-6638 | Digestive Endoscopy, Pa 17322 91st Ave N Maple Grove MN 55311-5403 Ph: (763) 416-0399 |
| NPI Number | 1144588773 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 05/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144588773 | NPI | - | NPPES |
| 255716900 | Medicaid | MN | |
| 1033127964 | Other | MN | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 19698 (Minnesota) | Primary |
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