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1050 Larpenteur Ave W Saint Paul MN 55113-6556 | |
(651) 487-2831 | |
(651) 487-1705 |
Full Name | |
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Speciality | Family Medicine |
Location | 1050 Larpenteur Ave W, Saint Paul, Minnesota |
Authorized Official Name and Position | Keith A Oelschlager (MINNHEALTH PRESIDENT) |
Authorized Official Contact | 6517660520 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2025 Sloan Pl Suite 35 Saint Paul MN 55117-2007 Ph: (651) 772-2262 | 1050 Larpenteur Ave W Saint Paul MN 55113-6556 Ph: (651) 487-2831 |
NPI Number | 1780801894 |
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Provider Enumeration Date | 04/19/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1780801894 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 1124 (Minnesota) | 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 |