| Little Canada Medical Clinic | |
|
75 Little Canada Rd W Little Canada MN 55117-1362 | |
| (651) 481-1119 | |
| (651) 481-1476 |
| Full Name | Little Canada Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 75 Little Canada Rd W, Little Canada, Minnesota |
| Authorized Official Name and Position | James William Allan (PRESIDENT) |
| Authorized Official Contact | 6514811119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Canada Medical Clinic 75 Little Canada Rd W Little Canada MN 55117-1362 Ph: (651) 481-1119 | Little Canada Medical Clinic 75 Little Canada Rd W Little Canada MN 55117-1362 Ph: (651) 481-1119 |
| NPI Number | 1174836597 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 07/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174836597 | NPI | - | NPPES |
| D80937 | Other | MN | UPIN |
| 0123164 | Other | MN | MEDICA |
| 263273000 | Medicaid | MN | |
| 20504LI | Other | MN | BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 20780 (Minnesota) | Primary |
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