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NPI Code Detail

MEDICARE: DR. VIRGINIA DALE MD

MEDICARE:  DR. VIRGINIA  DALE  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
1207ZP0101XAnatomic Pathology Physician29849MN
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician29849MN

General Provider Information

NPI Number : 1689635070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIRGINIA DALE MD
Provider Business Mailing Address
First Line : NW 6164
Second Line : PO BOX 1450
City : MINNEAPOLIS
State : MN
Zip : 55485-6164
Country : US
Telephone Number : 877-861-9294
Fax Number :
Provider Business Practice Location Address
First Line : 3300 OAKDALE AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55422
Country : US
Telephone Number : 763-520-5521
Fax Number : 763-520-1721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 07/09/2018

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Directions to “ DR. VIRGINIA DALE MD” Practice Location

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