| Doctor's House | |
|
6565 France Ave S Ste 350 Edina MN 55435-2137 | |
| (612) 836-9412 | |
| Not Available |
| Full Name | Doctor's House |
|---|---|
| Speciality | Clinic/Center |
| Location | 6565 France Ave S Ste 350, Edina, Minnesota |
| Authorized Official Name and Position | Adepero Olufunmilayo Okulaja (OWNER) |
| Authorized Official Contact | 6128369412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor's House 6565 France Ave S # 350 Edina MN 55435-2137 Ph: (215) 668-7199 | Doctor's House 6565 France Ave S Ste 350 Edina MN 55435-2137 Ph: (612) 836-9412 |
| NPI Number | 1609389675 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 12/29/2017 |
| Medicare PECOS PAC ID | 7315206588 |
|---|---|
| Medicare Enrollment ID | O20180116000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609389675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 49342 (Minnesota) | Primary |
| Provider Name | Adepero Olufunmilayo Okulaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780794016 PECOS PAC ID: 1052313426 Enrollment ID: I20070214000101 |
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