| Essentia Health St. Mary's - Detroit Lakes Clinic | |
|
1027 Washington Ave Detroit Lakes MN 56501-3409 | |
| (218) 844-2300 | |
| Not Available |
| Full Name | Essentia Health St. Mary's - Detroit Lakes Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1027 Washington Ave, Detroit Lakes, Minnesota |
| Authorized Official Name and Position | Alan Hurley (COO) |
| Authorized Official Contact | 7013647667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentia Health St. Mary's - Detroit Lakes Clinic 1027 Washington Ave Detroit Lakes MN 56501-3409 Ph: (218) 844-2300 | Essentia Health St. Mary's - Detroit Lakes Clinic 1027 Washington Ave Detroit Lakes MN 56501-3409 Ph: (218) 844-2300 |
| NPI Number | 1639513377 |
|---|---|
| Provider Enumeration Date | 04/24/2013 |
| Last Update Date | 03/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639513377 | NPI | - | NPPES |
| 892442000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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