Healthcare Provider Details
I. General information
NPI: 1669133203
Provider Name (Legal Business Name): MARGARET MARIE MCCABE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2022
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 SAINT JOHNS BLVD STE 200
MAPLEWOOD MN
55109-1190
US
IV. Provider business mailing address
1600 SAINT JOHNS BLVD STE 200
MAPLEWOOD MN
55109-1190
US
V. Phone/Fax
- Phone: 651-326-4327
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 14411 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: