| Southdale Physicians, Llc | |
|
6565 France Ave S Ste 350 Edina MN 55435-2137 | |
| (612) 430-8120 | |
| Not Available |
| Full Name | Southdale Physicians, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6565 France Ave S Ste 350, Edina, Minnesota |
| Authorized Official Name and Position | Merlin Brown (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6124308120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southdale Physicians, Llc 6565 France Ave S Ste 350 Edina MN 55435-2137 Ph: () - | Southdale Physicians, Llc 6565 France Ave S Ste 350 Edina MN 55435-2137 Ph: (612) 430-8120 |
| NPI Number | 1124569249 |
|---|---|
| Provider Enumeration Date | 03/09/2017 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 6204109051 |
|---|---|
| Medicare Enrollment ID | O20170830002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124569249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 38120 (Minnesota) | Primary |
| Provider Name | Merlin E Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053317354 PECOS PAC ID: 2668374083 Enrollment ID: I20050603000795 |
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