Healthcare Provider Details

I. General information

NPI: 1851281133
Provider Name (Legal Business Name): MINNESOTA ONCOLOGY HEMATOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 FRANCE AVE S STE 400
EDINA MN
55435-2142
US

IV. Provider business mailing address

2550 UNIVERSITY AVE W STE 110N
SAINT PAUL MN
55114-8693
US

V. Phone/Fax

Practice location:
  • Phone: 651-312-1700
  • Fax: 952-920-4148
Mailing address:
  • Phone: 651-602-5309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE WALKER
Title or Position: CRED COORDINATOR
Credential:
Phone: 651-602-5309