institution
Pediatric And Young Adult Medicine, Pa
Primary Care Clinic/Center in Lake Elmo, Minnesota
NPI 1457593550

Pediatric And Young Adult Medicine, Pa is a Primary Care Clinic/Center based in Saint Paul, MN and is specialized in Primary Care. Pediatric And Young Adult Medicine, Pa practices in Lake Elmo, MN. The NPI Number for Pediatric And Young Adult Medicine, Pa is 1457593550 and holds a License No. 154 (Minnesota).

The current practice location address for Pediatric And Young Adult Medicine, Pa is 8650 Hudson Blvd N, Lake Elmo, MN and can be reached out via phone at 651-256-6706 and via fax at 651-256-6707.

Location: 8650 Hudson Blvd N, Lake Elmo, MN, 55116-2300
institution
Provider Profile Details
NPI Number
1457593550
Provider Name
Pediatric And Young Adult Medicine, Pa
Credential
Provider Entity Type
Organization
Address
8650 Hudson Blvd N, Lake Elmo, MN, 55116-2300
Phone Number
651-256-6706
Fax Number
651-256-6707
Provider Enumeration Date
04/03/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104806165 05 MN
1245210095 05 MN
1245210210 05 MN
1861558835 05 MN
1083694046 05 MN
1477870921 05 MN
1386991339 05 MN
1881057065 05 MN
1912987900 05 MN
1497735419 05 MN
institution
Provider Business Practice Location Address Details
Address
8650 Hudson Blvd N
City
State
Zip
55042-9747
Phone Number
651-256-6706
Fax Number
651-256-6707
person
Provider Business Mailing Address Details
Address
8650 Hudson Blvd N
City
State
Zip
55042-9747
Phone Number
651-256-6706
Fax Number
651-256-6707
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
154 (Minnesota)
Definition
Definition to come...
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