Unknown Individual – Family Medicine Physician, NPI 1457353864
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
7801, East Bush Lake Road, Cahill, Bloomington, Hennepin County, Minnesota, 55439, United States
STE 300
BLOOMINGTON, MN 554393114
Phone: (952) 985-8911
Fax: (952) 985-8999
Type: Mailing
14000, Nicollet Avenue South, Burnsville, Dakota County, Minnesota, 55337, United States
BURNSVILLE, MN 553375790
Phone: (952) 985-8200
Fax: (952) 985-8299
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 ·
Educational use only—not medical, billing, or legal advice.
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 ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55439)
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