MEDICARE: FAIRVIEW CLINICS

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	261QP2300X	Primary Care Clinic/Center

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	:	1790977486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW CLINICS

Provider Business Mailing Address
First Line	:	1700 UNIVERSITY AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-3727
Country	:	US
Telephone Number	:	612-672-6740
Fax Number	:	612-884-3592

Provider Business Practice Location Address
First Line	:	6320 WEDGEWOOD RD N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-3647
Country	:	US
Telephone Number	:	763-268-0400
Fax Number	:	763-268-0405

Authorized Official
Title or Position	:	SYS DIR GOVT REIMB & NETWK REL
Name	:	MAUREEN V RING
Credential	:
Telephone Number	:	612-672-6740

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	02/28/2025

Similar Medicare Providers

1043204647 — RHONDA MARIE WOLFE MSN
Practice Location Address:

6300 WEDGWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 866-389-2727
Practice Fax:

1962485680 — SHARI L GERMSCHEID NP
Practice Location Address:

6320 WEDGEWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 763-268-0400
Practice Fax:

1205852480 — PAMELA KOLACZ M.D.
Practice Location Address:

6320 WEDGWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 763-268-0400
Practice Fax: 763-268-0405

1538278791 — CHRISTINE ELIZABETH BOUMANN PA-C
Practice Location Address:

6320 WEDGWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 763-268-0400
Practice Fax: 763-268-0405

1184863938 — DR. SRINIVASA REDDY VAKA MD
Practice Location Address:

FAIRVIEW CLINICS-BASS LAKE , 6320 WEDGWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 763-268-0400
Practice Fax: 763-268-0405

1184921264 — FAISO ABDULLE NURSE PRACTITIONER
Practice Location Address:

6300 WEDGWOOD RD N
MAPLE GROVE, MN
55311-3647

Practice Phone: 763-551-1215
Practice Fax:

Directions to “FAIRVIEW CLINICS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.