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General NPI Number Information
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NPI Number | 1558421792
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN NEWBORN MEDICINE,P.A.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 347 SMITH AVE N SUITE 505
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City | SAINT PAUL
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State | MN
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Zip | 55102-2387
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Country | US
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Telephone | 651-426-0698
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Fax | 651-426-6439
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Provider Business Mailing Address
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Address Line | 1835 COUNTY ROAD C W STE 30
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City | ROSEVILLE
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State | MN
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Zip | 55113-1125
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Country | US
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Telephone | 651-426-0698
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Fax | 651-426-6439
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | MELISSA MAHMOOD-THIES
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Credential |
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Telephone | 651-426-0698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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