Healthcare Provider Details

I. General information

NPI: 1073645248
Provider Name (Legal Business Name): Y.STURM, M.D., PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 DREW AVE S
EDINA MN
55435-2103
US

IV. Provider business mailing address

6525 DREW AVE S
EDINA MN
55435-2103
US

V. Phone/Fax

Practice location:
  • Phone: 952-920-6748
  • Fax: 952-920-3863
Mailing address:
  • Phone: 952-920-6748
  • Fax: 952-920-3863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number44268
License Number StateMN

VIII. Authorized Official

Name: MS. BEV KRIEG
Title or Position: OFFICE MANAGER
Credential:
Phone: 952-920-6825