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
1	291U00000X	Clinical Medical Laboratory	20020	MN

General Provider Information

NPI Number	:	1467850206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF MINNESOTA PHYSICIANS

Provider Business Mailing Address
First Line	:	420 DELAWARE ST SE
Second Line	:	MMC 134
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0341
Country	:	US
Telephone Number	:	612-273-5858
Fax Number	:	612-625-7230

Provider Business Practice Location Address
First Line	:	1200 WASHINGTON AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1295
Country	:	US
Telephone Number	:	612-625-4448
Fax Number	:

Authorized Official
Title or Position	:	OUTREACH LABS MEDICAL DIRECTOR
Name	:	DR. PATRICIA FERRIERI
Credential	:	MD
Telephone Number	:	612-273-5858

Provider Enumeration Date	:	12/10/2014
Last Update Date	:	06/29/2020

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