| Fastcare Of Tcmc | |
|
4601 Excelsior Blvd Ste 407 Saint Louis Park MN 55416-4977 | |
| (952) 926-0025 | |
| (952) 926-0376 |
| Full Name | Fastcare Of Tcmc |
|---|---|
| Speciality | Family Medicine |
| Location | 4601 Excelsior Blvd Ste 407, Saint Louis Park, Minnesota |
| Authorized Official Name and Position | Claes Erik Michael Oldenburg (PRESIDENT) |
| Authorized Official Contact | 6122291171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fastcare Of Tcmc 2701 Sunset Blvd Minneapolis MN 55416-4271 Ph: (612) 229-1171 | Fastcare Of Tcmc 4601 Excelsior Blvd Ste 407 Saint Louis Park MN 55416-4977 Ph: (952) 926-0025 |
| NPI Number | 1982802773 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 09/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982802773 | NPI | - | NPPES |
| 3618 | Other | MN | HEALTHPARTNERS |
| 68944000 | Medicaid | MN | |
| 407A8AM | Other | MN | BCBSMN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 38041 (Minnesota) | Primary |
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