MEDICARE: DR. CHARLES O FINNE III 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	208C00000X	Colon & Rectal Surgery Physician	25240	MN

Other Identifiers

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

General Provider Information

NPI Number	:	1548215767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES O FINNE III MD

Provider Business Mailing Address
First Line	:	1055 WESTGATE DR
Second Line	:	SUITE 190
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1065
Country	:	US
Telephone Number	:	651-312-1500
Fax Number	:	651-312-1595

Provider Business Practice Location Address
First Line	:	2800 CHICAGO AVE S
Second Line	:	SUITE 300
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1353
Country	:	US
Telephone Number	:	651-225-7855
Fax Number	:	651-225-7878

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	02/26/2010

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