| |
3501 Douglas Dr N Crystal MN 55422-2415 | |
(763) 535-9601 | |
(763) 535-5601 |
Full Name | |
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Speciality | Family Medicine |
Location | 3501 Douglas Dr N, Crystal, Minnesota |
Authorized Official Name and Position | Roxanne M Urbashich (OFFICE MANAGER) |
Authorized Official Contact | 7635359601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3501 Douglas Dr N Crystal MN 55422-2415 Ph: (763) 535-9601 | 3501 Douglas Dr N Crystal MN 55422-2415 Ph: (763) 535-9601 |
NPI Number | 1366628554 |
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Provider Enumeration Date | 01/17/2008 |
Last Update Date | 01/08/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366628554 | NPI | - | NPPES |
0005733572 | Other | AETNA | |
442672100 | Medicaid | MN | |
085N8NE | Other | BLUES | |
P044 | Other | UCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
River Place By Serenity, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2756 Douglas Dr N, Crystal, MN 55422 Phone: 763-421-5590 | |
Odam Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6014 Lakeland Ave N, Crystal, MN 55428 Phone: 612-871-2312 Fax: 612-871-2163 | |
Crystal New Hope Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3501 Douglas Dr N, Crystal, MN 55422 Phone: 763-535-9601 Fax: 763-535-5601 | |