Healthcare Provider Details

I. General information

NPI: 1235191149
Provider Name (Legal Business Name): ANITA M STREI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S. SIBLEY AVE AFFILIATED COMMUNITY MEDICAL CENTERS
LITCHFIELD MN
55355
US

IV. Provider business mailing address

520 S. SIBLEY AVE AFFILIATED COMMUNITY MEDICAL CENTERS
LITCHFIELD MN
55355
US

V. Phone/Fax

Practice location:
  • Phone: 320-693-3233
  • Fax: 320-693-3290
Mailing address:
  • Phone: 320-693-3233
  • Fax: 320-693-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36726
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: