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NPI Code Detail

MEDICARE: DR. MARICELA CONTRERAS M.D.

MEDICARE: DR. MARICELA CONTRERAS M.D.
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
12085R0202XDiagnostic Radiology PhysicianG87903CA

General Provider Information

NPI Number : 1396736112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARICELA CONTRERAS M.D.
Provider Business Mailing Address
First Line : 4801 VETERANS DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-255-6410
Fax Number :
Provider Business Practice Location Address
First Line : 4801 VETERANS DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-255-6410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2005
Last Update Date : 10/22/2025

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Directions to “ DR. MARICELA CONTRERAS M.D.” Practice Location

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