| Wellington Provider Group Pc | |
|
121 Washington Ave N Fl 4 Minneapolis MN 55401-2503 | |
| (859) 493-2812 | |
| Not Available |
| Full Name | Wellington Provider Group Pc |
|---|---|
| Speciality | General Practice |
| Location | 121 Washington Ave N Fl 4, Minneapolis, Minnesota |
| Authorized Official Name and Position | Brittany Dennis (BILLING/CREDENTIALING MANAGER) |
| Authorized Official Contact | 8595188817 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellington Provider Group Pc 535 Wellington Way Ste 330 Lexington KY 40503-1331 Ph: (859) 439-0400 | Wellington Provider Group Pc 121 Washington Ave N Fl 4 Minneapolis MN 55401-2503 Ph: (859) 493-2812 |
| NPI Number | 1205543246 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 01/24/2023 |
| Medicare PECOS PAC ID | 8123412459 |
|---|---|
| Medicare Enrollment ID | O20230208003107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205543246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Carl Seger |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699957308 PECOS PAC ID: 1951455773 Enrollment ID: I20230209001216 |
| Provider Name | Kyle George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982199519 PECOS PAC ID: 4688909690 Enrollment ID: I20230328002188 |
| Provider Name | Jeremy Stich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295027126 PECOS PAC ID: 7416133616 Enrollment ID: I20230516002308 |
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