Healthcare Provider Details

I. General information

NPI: 1447241799
Provider Name (Legal Business Name): MICHAEL PATRICK O'ROURKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 1ST ST NE
NEW PRAGUE MN
56071-2215
US

IV. Provider business mailing address

1411 7TH STREET CT SE
NEW PRAGUE MN
56071-5400
US

V. Phone/Fax

Practice location:
  • Phone: 652-758-2535
  • Fax: 952-548-6160
Mailing address:
  • Phone: 952-758-2535
  • Fax: 952-548-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44791
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number44791
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number44791
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number44791
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44791
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: