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NPI Code Detail

MEDICARE: CONSTANCE M ERDMANN MD

MEDICARE: CONSTANCE M ERDMANN 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
1207Q00000XFamily Medicine Physician26942MN

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 : 1871504977
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSTANCE M ERDMANN MD
Provider Business Mailing Address
First Line : 2025 SLOAN PL
Second Line : STE 35
City : SAINT PAUL
State : MN
Zip : 55117-2007
Country : US
Telephone Number : 651-772-1572
Fax Number : 651-772-1889
Provider Business Practice Location Address
First Line : 2980 BUCKLEY WAY
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55076-2017
Country : US
Telephone Number : 651-457-2748
Fax Number : 651-457-0822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 10/14/2011

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