| Fairview Clinics-maple Grove | |
|
14500 99th Ave N Ste 100 Maple Grove MN 55369-4478 | |
| (763) 898-1000 | |
| (763) 898-1009 |
| Full Name | Fairview Clinics-maple Grove |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 14500 99th Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Maureen Ring (DIRECTOR NETWORK RELATIONS AO) |
| Authorized Official Contact | 6126726740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Clinics-maple Grove Po Box 9372 Minneapolis MN 55440-9372 Ph: (612) 672-6724 | Fairview Clinics-maple Grove 14500 99th Ave N Ste 100 Maple Grove MN 55369-4478 Ph: (763) 898-1000 |
| NPI Number | 1841315165 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 10/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841315165 | NPI | - | NPPES |
| 837428100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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