MEDICARE: COURTNEY E BARANCIN 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	207RG0100X	Gastroenterology Physician	51854	MN

General Provider Information

NPI Number	:	1336116920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY E BARANCIN MD

Provider Business Mailing Address
First Line	:	PO BOX 14909
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-0909
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

Provider Business Practice Location Address
First Line	:	1185 TOWN CENTRE DR
Second Line	:	SUITE 205
City	:	EAGAN
State	:	MN
Zip	:	55123-1187
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	05/20/2014

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Directions to “ COURTNEY E BARANCIN MD” Practice Location

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