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General NPI Number Information
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NPI Number | 1922670215
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Entity Type | Organization
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Legal Business Name | STAT HEALTH CARE PLLC
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 425 MINNEHAHA AVE EAST 600532
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City | SAINT PAUL
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State | MN
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Zip | 55106
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Country | US
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Telephone | 651-808-8886
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Fax |
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Provider Business Mailing Address
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Address Line | 425 MINNEHAHA AVE EAST 600532
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City | SAINT PAUL
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State | MN
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Zip | 55106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOSHMAND LAS
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Credential | PA-C
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Telephone | 651-808-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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