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45 10th St W Saint Paul MN 55102-1062 | |
(651) 326-2400 | |
(651) 326-2440 |
Full Name | |
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Speciality | Family Medicine |
Location | 45 10th St W, Saint Paul, 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 |
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1700 University Ave W Saint Paul MN 55104-3727 Ph: (612) 672-6740 | 45 10th St W Saint Paul MN 55102-1062 Ph: (651) 326-2400 |
NPI Number | 1720248966 |
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Provider Enumeration Date | 06/11/2008 |
Last Update Date | 11/20/2023 |
Identifier | Type | State | Issuer |
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1720248966 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |