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5200 Fairview Blvd Wyoming MN 55092-8013 | |
(651) 982-7000 | |
Not Available |
Full Name | |
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Speciality | General Practice |
Location | 5200 Fairview Blvd, Wyoming, Minnesota |
Authorized Official Name and Position | Maureen Ring (DIRECTOR, NETWORK RELATIONS) |
Authorized Official Contact | 6126726740 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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400 Stinson Blvd Minneapolis MN 55413-2613 Ph: (612) 672-2258 | 5200 Fairview Blvd Wyoming MN 55092-8013 Ph: (651) 982-7000 |
NPI Number | 1902414378 |
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Provider Enumeration Date | 07/21/2020 |
Last Update Date | 11/15/2023 |
Identifier | Type | State | Issuer |
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1902414378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |