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NPI Code Detail

MEDICARE: JAMES A D'ORTA MD PC

MEDICARE: JAMES A D'ORTA MD PC
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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1548202252
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES A D'ORTA MD PC
Provider Business Mailing Address
First Line : 333 WASHINGTON AVE N
Second Line : # 5000
City : MINNEAPOLIS
State : MN
Zip : 55401-1377
Country : US
Telephone Number : 612-659-7111
Fax Number : 612-659-7101
Provider Business Practice Location Address
First Line : 845 BLADENSBURG RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-3927
Country : US
Telephone Number : 612-659-7111
Fax Number : 612-659-7101
Authorized Official
Title or Position : SENIOR CREDENTIALING SPECIALIST
Name : LISA MATTSON
Credential :
Telephone Number : 612-767-1947
Provider Enumeration Date : 06/10/2006
Last Update Date : 08/22/2020

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