My Medical Clinic Pllc | |
1560 Beam Ave Maplewood MN 55109-1191 | |
(651) 484-6923 | |
Not Available |
Full Name | My Medical Clinic Pllc |
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Speciality | Clinic/Center |
Location | 1560 Beam Ave, Maplewood, Minnesota |
Authorized Official Name and Position | Chaitanya Anand (CMD/FOUNDER AND OWNER) |
Authorized Official Contact | 6514846923 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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My Medical Clinic Pllc 4872 Steeplechase Way Eagan MN 55122-2978 Ph: (651) 484-6923 | My Medical Clinic Pllc 1560 Beam Ave Maplewood MN 55109-1191 Ph: (651) 484-6923 |
NPI Number | 1215344742 |
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Provider Enumeration Date | 07/16/2014 |
Last Update Date | 10/12/2022 |
Medicare PECOS PAC ID | 4587986112 |
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Medicare Enrollment ID | O20141209001955 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215344742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 45908 (Minnesota) | Primary |
Provider Name | Chaitanya Anand |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275599136 PECOS PAC ID: 4183679004 Enrollment ID: I20050314000831 |
Provider Name | Bhavana C Anand |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1932343969 PECOS PAC ID: 9032431747 Enrollment ID: I20141209000715 |
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