Unknown Individual – Anesthesiology Physician, NPI 1114039633
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Eagle Point Boulevard, Lake Elmo, Washington County, Minnesota, 55125, United States
LAKE ELMO, MN 550428628
Phone: (651) 251-8021
Fax: (651) 251-8050
Type: Mailing
St. John's Hospital, 1575, Beam Avenue, Maplewood, Ramsey County, Minnesota, 55109, United States
MAPLEWOOD, MN 551091126
Phone: (651) 735-0501
Fax: (651) 735-1870
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
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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 55042)
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