Unknown Individual – Surgery Physician, NPI 1003869637
Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
2211 PRINCETON AVE
SAINT PAUL, MN 551051122
Phone: (651) 769-4530
Type: Mailing
3001 SANFORD PKWY
THIEF RIVER FALLS, MN 567012700
Phone: (218) 681-4747
Type: Location
Olmsted Medical Center Southeast, 210, 9th Street Southeast, Rochester, Olmsted County, Minnesota, 55904, United States
ROCHESTER, MN 559046425
Phone: (507) 288-3443
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Clinical Social Worker | SD | |
| Interventional Pain Management, Pain Management, Anesthesiology, Critical Care (Intensivists), Internal Medicine | ND | |
| Nurse Practitioner | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Nurse Practitioner | MN | |
| Family Practice | ND | |
| Family Practice | SD | |
| Internal Medicine | MN | |
| Family Practice | ND |
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