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General NPI Number Information
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NPI Number | 1972906097
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL CONSULTING, INC.
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 7240 BROOKLYN BLVD STE 200
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City | BROOKLYN PARK
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State | MN
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Zip | 55429-1280
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Country | US
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Telephone | 612-875-2733
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Fax | 763-428-8495
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Provider Business Mailing Address
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Address Line | 7240 BROOKLYN BLVD STE 200
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City | BROOKLYN PARK
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State | MN
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Zip | 55429-1280
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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 | PARTNER
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Name | RUSSELL ROONEY
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Credential |
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Telephone | 612-875-2733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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