Healthcare Provider Details

I. General information

NPI: 1942245881
Provider Name (Legal Business Name): SAGE WEIGHT AND WELLNESS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MAIN ST W SUITE 130
NEW PRAGUE MN
56071-2335
US

IV. Provider business mailing address

210 MAIN ST W SUITE 130
NEW PRAGUE MN
56071-2335
US

V. Phone/Fax

Practice location:
  • Phone: 952-758-8885
  • Fax:
Mailing address:
  • Phone: 952-758-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MILAN C SCHMIDT
Title or Position: PRESIDENT
Credential: MD
Phone: 651-842-3344