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General NPI Number Information
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NPI Number | 1467850206
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MINNESOTA PHYSICIANS
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 1200 WASHINGTON AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55415-1295
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Country | US
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Telephone | 612-625-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE ST SE MMC 134
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0341
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Country | US
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Telephone | 612-273-5858
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Fax | 612-625-7230
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Authorized Official
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Title or Position | OUTREACH LABS MEDICAL DIRECTOR
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Name | DR. PATRICIA FERRIERI
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Credential | MD
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Telephone | 612-273-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 20020
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License Number State | MN
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