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NPI Code Detail

MEDICARE: UNIVERSITY OF MINNESOTA PHYSICIANS

MEDICARE: UNIVERSITY OF MINNESOTA PHYSICIANS
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
1261QP2300XPrimary Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1366589962
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF MINNESOTA PHYSICIANS
Provider Business Mailing Address
First Line : 720 WASHINGTON AVE SE STE 200
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-2924
Country : US
Telephone Number : 612-884-0600
Fax Number :
Provider Business Practice Location Address
First Line : 2426 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-1735
Country : US
Telephone Number : 612-302-8200
Fax Number : 612-302-8275
Authorized Official
Title or Position : CFO
Name : WILLIAM SIBERT
Credential :
Telephone Number : 312-560-5317
Provider Enumeration Date : 01/31/2007
Last Update Date : 12/04/2024

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Directions to “UNIVERSITY OF MINNESOTA PHYSICIANS ” Practice Location

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