Unknown Individual – Psychiatry Physician, NPI 1083633325
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1900, Silver Lake Road Northwest, New Brighton, Ramsey County, Minnesota, 55112, United States
SUITE 110
NEW BRIGHTON, MN 551121786
Phone: (651) 628-9566
Fax: (651) 628-0411
Type: Mailing
7300, 147th Street West, Apple Valley, Dakota County, Minnesota, 55124, United States
SUITE 204
APPLE VALLEY, MN 551247541
Phone: (952) 997-3020
Fax: (952) 997-3026
Type: Location
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
Source: CMS public data · Not endorsed by CMS ·
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55112)
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