| |
4801 15th Ave S Minneapolis MN 55417-1126 | |
(651) 424-2241 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 4801 15th Ave S, Minneapolis, Minnesota |
Authorized Official Name and Position | Michelle Spies Haggerty (OWNER/FOUNDER/PHYSICIAN) |
Authorized Official Contact | 6124242241 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12105 29th Ave N Plymouth MN 55441-2955 Ph: (612) 424-2241 | 4801 15th Ave S Minneapolis MN 55417-1126 Ph: (651) 424-2241 |
NPI Number | 1629742903 |
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Provider Enumeration Date | 08/02/2021 |
Last Update Date | 12/31/2023 |
Identifier | Type | State | Issuer |
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1629742903 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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