MEDICARE: MAREN ELZE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	599	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073545851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAREN ELZE DPM

Provider Business Mailing Address
First Line	:	PO BOX 43
Second Line	:	MR 10860
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55440-0043
Country	:	US
Telephone Number	:	612-262-1166
Fax Number	:	612-262-9035

Provider Business Practice Location Address
First Line	:	1155 COUNTY ROAD E E STE 100
Second Line	:
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110-5191
Country	:	US
Telephone Number	:	651-241-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/12/2023

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