St Cloud Medical Group Pa | |
251 County Road 120 Saint Cloud MN 56303-4872 | |
(320) 202-8949 | |
(320) 202-0756 |
Full Name | St Cloud Medical Group Pa |
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Speciality | Clinic/center - Multi-specialty |
Location | 251 County Road 120, Saint Cloud, Minnesota |
Authorized Official Name and Position | Christopher Tacl (MEDICAL DIRECTOR) |
Authorized Official Contact | 3202028949 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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St Cloud Medical Group Pa 251 County Road 120 Saint Cloud MN 56303-4872 Ph: (320) 202-8949 | St Cloud Medical Group Pa 251 County Road 120 Saint Cloud MN 56303-4872 Ph: (320) 202-8949 |
NPI Number | 1487690996 |
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Provider Enumeration Date | 06/22/2006 |
Last Update Date | 10/06/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487690996 | NPI | - | NPPES |
175710500 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Aba Community Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Wilson Ave Ne Ste 101, Saint Cloud, MN 56304 Phone: 320-420-3168 Fax: 320-968-1251 | |
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