Healthcare Provider Details

I. General information

NPI: 1700217296
Provider Name (Legal Business Name): ONCALL CLINICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5861 CEDAR LAKE ROAD
ST LOUIS PARK MN
55416-1653
US

IV. Provider business mailing address

5861 CEDAR LAKE RD S
ST LOUIS PARK MN
55416-1653
US

V. Phone/Fax

Practice location:
  • Phone: 763-544-1000
  • Fax: 612-225-1834
Mailing address:
  • Phone: 763-544-5000
  • Fax: 612-225-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JUDY GOLDETSKY
Title or Position: CEO
Credential: EXECUTIVE DIRECTOR
Phone: 763-544-6000