Healthcare Provider Details

I. General information

NPI: 1629193446
Provider Name (Legal Business Name): METROPOLITAN INTERNISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S 8TH ST SUITE #600 PARKSIDE PROF BLDG
MINNEAPOLIS MN
55404-1208
US

IV. Provider business mailing address

825 S 8TH ST SUITE #600 PARKSIDE PROF BLDG
MINNEAPOLIS MN
55404-1208
US

V. Phone/Fax

Practice location:
  • Phone: 612-339-7171
  • Fax: 612-339-2885
Mailing address:
  • Phone: 612-339-7171
  • Fax: 612-339-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number StateMN

VIII. Authorized Official

Name: MRS. DAWN E MEYERS
Title or Position: MANAGER ADMINISTRATOR
Credential:
Phone: 612-339-7171