| Pediatric And Young Adult Medicine, Pa | |
|
8650 Hudson Blvd N Suite 125 Lake Elmo MN 55042-9747 | |
| (651) 256-6706 | |
| (651) 256-6707 |
| Full Name | Pediatric And Young Adult Medicine, Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 8650 Hudson Blvd N, Lake Elmo, Minnesota |
| Authorized Official Name and Position | Terri M Joseph (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 6512566706 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric And Young Adult Medicine, Pa 1804 7th St W Suite 200 Saint Paul MN 55116-2300 Ph: (651) 256-6706 | Pediatric And Young Adult Medicine, Pa 8650 Hudson Blvd N Suite 125 Lake Elmo MN 55042-9747 Ph: (651) 256-6706 |
| NPI Number | 1457593550 |
|---|---|
| Provider Enumeration Date | 04/03/2009 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457593550 | NPI | - | NPPES |
| 1104806165 | Medicaid | MN | |
| 1245210095 | Medicaid | MN | |
| 1245210210 | Medicaid | MN | |
| 1861558835 | Medicaid | MN | |
| 1083694046 | Medicaid | MN | |
| 1477870921 | Medicaid | MN | |
| 1386991339 | Medicaid | MN | |
| 1881057065 | Medicaid | MN | |
| 1912987900 | Medicaid | MN | |
| 1497735419 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 154 (Minnesota) | Primary |
Hamerly Health Care Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9429 Jane Rd N, Lake Elmo, MN 55042 Phone: 651-235-4060 | |
Healthpartners Substance Use Disorder Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8550 Hudson Blvd N, Lake Elmo, MN 55042 Phone: 651-254-1616 Fax: 651-254-0601 | |
Simply Chiropractic, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10037 Tapestry Rd, Lake Elmo, MN 55042 Phone: 612-207-3112 |