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NPI Code Detail

MEDICARE: ERIC JOHN DECUIR PA

MEDICARE: ERIC JOHN DECUIR PA
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
1363AS0400XSurgical Physician Assistant10384MN
2207T00000XNeurological Surgery Physician10384MN

General Provider Information

NPI Number : 1114900966
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC JOHN DECUIR PA
Provider Business Mailing Address
First Line : 800 E 28TH ST
Second Line : SUITE 305 PIPER BUILDING
City : MINNEAPOLIS
State : MN
Zip : 55407-3723
Country : US
Telephone Number : 612-871-7278
Fax Number :
Provider Business Practice Location Address
First Line : 913 E 26TH ST
Second Line : SUITE 305 PIPER BUILDING
City : MINNEAPOLIS
State : MN
Zip : 55404-4515
Country : US
Telephone Number : 612-871-7278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 03/11/2021

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Directions to “ ERIC JOHN DECUIR PA” Practice Location

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