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1502 London Rd Ste 102 Duluth MN 55812-1787 | |
(218) 576-0100 | |
(218) 576-0126 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 1502 London Rd Ste 102, Duluth, Minnesota |
Authorized Official Name and Position | Kevin Boren (VP OF FINANCE) |
Authorized Official Contact | 2187861009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1502 London Rd Ste 102 Duluth MN 55812-1787 Ph: (218) 576-0100 | 1502 London Rd Ste 102 Duluth MN 55812-1787 Ph: (218) 576-0100 |
NPI Number | 1275839193 |
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Provider Enumeration Date | 02/10/2011 |
Last Update Date | 02/28/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275839193 | NPI | - | NPPES |
1275839193 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (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 | |
St. Luke's Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5232 | |
Mission Creek Transitional Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Marshall St, Duluth, MN 55803 Phone: 218-340-8674 |