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1083665913

NPI Code Detail

MEDICARE: DR. MICHAEL H FARRELL MD

MEDICARE: DR. MICHAEL H FARRELL MD

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	207R00000X	Internal Medicine Physician	46812	WI
2	208000000X	Pediatrics Physician	46812	WI
3	208000000X	Pediatrics Physician	62082	MN

General Provider Information

NPI Number	:	1083665913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H FARRELL MD

Provider Business Mailing Address
First Line	:	8170 33RD AVE S # MS 21110Q
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-4516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9555 UPLAND LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4485
Country	:	US
Telephone Number	:	952-993-1440
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	06/27/2025

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Directions to “ DR. MICHAEL H FARRELL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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