MEDICARE: AALFA FAMILY PRACTICE 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
1	207Q00000X	Family Medicine Physician		MN
2	207R00000X	Internal Medicine Physician		MN

General Provider Information

NPI Number	:	1437150877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AALFA FAMILY PRACTICE PA

Provider Business Mailing Address
First Line	:	4465 WHITE BEAR PKWY
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-7626
Country	:	US
Telephone Number	:	651-653-0062
Fax Number	:	651-653-0288

Provider Business Practice Location Address
First Line	:	4465 WHITE BEAR PKWY
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-7626
Country	:	US
Telephone Number	:	651-653-0062
Fax Number	:	651-653-0288

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL J SPENCER
Credential	:	DO
Telephone Number	:	651-653-0062

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/11/2025

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