| Midway Medical Clinic Steven P. Radjenovich D.o. Llc | |
|
119 30th Ave W Alexandria MN 56308-3433 | |
| (320) 763-6452 | |
| (320) 763-2971 |
| Full Name | Midway Medical Clinic Steven P. Radjenovich D.o. Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 119 30th Ave W, Alexandria, Minnesota |
| Authorized Official Name and Position | Steven Perl Radjenovich (PRESIDENT) |
| Authorized Official Contact | 3207636452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Medical Clinic Steven P. Radjenovich D.o. Llc 119 30th Ave W Alexandria MN 56308-3433 Ph: (320) 763-6452 | Midway Medical Clinic Steven P. Radjenovich D.o. Llc 119 30th Ave W Alexandria MN 56308-3433 Ph: (320) 763-6452 |
| NPI Number | 1184610974 |
|---|---|
| Provider Enumeration Date | 09/27/2005 |
| Last Update Date | 01/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184610974 | NPI | - | NPPES |
| 449883600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 22233 (Minnesota) | Primary |
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