Pediatric And Young Adult Medicine, Pa | |
1804 7th St W Suite 200 Saint Paul MN 55116-2300 | |
(651) 227-7806 | |
(651) 256-6766 |
Full Name | Pediatric And Young Adult Medicine, Pa |
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Speciality | Clinic/center - Primary Care |
Location | 1804 7th St W, Saint Paul, 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 |
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Pediatric And Young Adult Medicine, Pa 1804 7th St W Suite 200 Saint Paul MN 55116-2300 Ph: (651) 227-7806 | Pediatric And Young Adult Medicine, Pa 1804 7th St W Suite 200 Saint Paul MN 55116-2300 Ph: (651) 227-7806 |
NPI Number | 1932316916 |
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Provider Enumeration Date | 05/17/2007 |
Last Update Date | 12/07/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932316916 | NPI | - | NPPES |
1083694046 | Medicaid | MN | |
1245210210 | Medicaid | MN | |
1912987900 | Medicaid | MN | |
1104806165 | Medicaid | MN | |
1245210095 | Medicaid | MN | |
1477870921 | Medicaid | MN | |
1881057065 | Medicaid | MN | |
1497735419 | Medicaid | MN | |
1861558835 | Medicaid | MN | |
1386991339 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 154 (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 |