Healthcare Provider Details

I. General information

NPI: 1134192628
Provider Name (Legal Business Name): MICHELLE R CILEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 EAST BROADWAY AFFILIATED COMMUNITY MEDICAL CENTERS
REDWOOD FALLS MN
56283
US

IV. Provider business mailing address

1100 EAST BROADWAY AFFILIATED COMMUNITY MEDICAL CENTERS
REDWOOD FALLS MN
56283
US

V. Phone/Fax

Practice location:
  • Phone: 507-637-2985
  • Fax:
Mailing address:
  • Phone: 507-637-2985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number39404
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: