Healthcare Provider Details

I. General information

NPI: 1093394611
Provider Name (Legal Business Name): ALEXANDER LOUIS BISCH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 96TH AVE N STE 200
BROOKLYN PARK MN
55443-4505
US

IV. Provider business mailing address

3500 AMERICAN BLVD W STE 300
BLOOMINGTON MN
55431-4442
US

V. Phone/Fax

Practice location:
  • Phone: 763-786-9543
  • Fax:
Mailing address:
  • Phone: 952-512-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number77132
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: