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General NPI Number Information
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NPI Number | 1174620447
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Entity Type | Organization
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Legal Business Name | CONSULTANTS INTERNAL MEDICINE, P.A.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 3400 W 66TH ST SUITE 385
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City | EDINA
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State | MN
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Zip | 55435-2111
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Country | US
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Telephone | 952-920-2761
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Fax | 952-920-0383
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Provider Business Mailing Address
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Address Line | 3400 W 66TH ST SUITE 385
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City | EDINA
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State | MN
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Zip | 55435-2111
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Country | US
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Telephone | 952-920-2761
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Fax | 952-920-0383
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BONNIE R BINA
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Credential | MHHSA
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Telephone | 952-915-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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