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14101 Fairview Dr Suite 300 Burnsville MN 55337-4590 | |
(952) 892-2650 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 14101 Fairview Dr, Burnsville, Minnesota |
Authorized Official Name and Position | Robert Andrew Mccoy (VP REVENUE MANAGEMENT) |
Authorized Official Contact | 6126726594 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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14101 Fairview Dr Suite 300 Burnsville MN 55337-4590 Ph: (952) 892-2650 | 14101 Fairview Dr Suite 300 Burnsville MN 55337-4590 Ph: (952) 892-2650 |
NPI Number | 1700258688 |
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Provider Enumeration Date | 10/30/2015 |
Last Update Date | 11/02/2020 |
Identifier | Type | State | Issuer |
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1700258688 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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