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1003991449

NPI Code Detail

MEDICARE: DR. SAUL AARRON MCBROOM MD

MEDICARE: DR. SAUL AARRON MCBROOM MD

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
1	207Q00000X	Family Medicine Physician	47721	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1032683	OTHER		PREFERRED ONE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	HP54877	OTHER		HEALTHPARTNERS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	106789	OTHER		UCARE
7	634T2SA	OTHER		BLUE CROSS BLUE SHIELD
8	66-08732	OTHER		MEDICA/URGENT CARE

General Provider Information

NPI Number	:	1003991449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAUL AARRON MCBROOM MD

Provider Business Mailing Address
First Line	:	5 W LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-3117
Country	:	US
Telephone Number	:	612-545-9250
Fax Number	:

Provider Business Practice Location Address
First Line	:	21260 CHIPPENDALE AVE W
Second Line	:
City	:	FARMINGTON
State	:	MN
Zip	:	55024-1427
Country	:	US
Telephone Number	:	651-463-7181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	03/11/2021

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Directions to “ DR. SAUL AARRON MCBROOM MD” Practice Location

Language	Start Address	Practice Location

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