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NPI Code Detail

MEDICARE: RIDGEVIEW CLINICS

MEDICARE: RIDGEVIEW CLINICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9792MN
2207X00000XOrthopaedic Surgery Physician40131MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003011768
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDGEVIEW CLINICS
Provider Business Mailing Address
First Line : 7907 POWERS BLVD
Second Line :
City : CHANHASSEN
State : MN
Zip : 55317-9502
Country : US
Telephone Number : 952-934-0570
Fax Number : 952-906-7891
Provider Business Practice Location Address
First Line : 7907 POWERS BLVD
Second Line :
City : CHANHASSEN
State : MN
Zip : 55317-9502
Country : US
Telephone Number : 952-934-0570
Fax Number : 952-906-7891
Authorized Official
Title or Position : OPERATIONS & BUSINESS OFFICE MANAGE
Name : KRISTI BESSE
Credential :
Telephone Number : 952-442-7895
Provider Enumeration Date : 06/20/2007
Last Update Date : 06/24/2009

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1205988714 — RIDGEVIEW CLINICS
Practice Location Address:
7907 POWERS BLVD
CHANHASSEN, MN
55317-9502
Practice Phone: 952-934-0570
Practice Fax: 952-906-7837

Directions to “RIDGEVIEW CLINICS ” Practice Location

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