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NPI Code Detail

MEDICARE: MICHAEL JAMES GREENSTEIN PA-C

MEDICARE: MICHAEL JAMES GREENSTEIN PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1801485255
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JAMES GREENSTEIN PA-C
Provider Business Mailing Address
First Line : 4064 KOKANEE LN N
Second Line :
City : LAKE ELMO
State : MN
Zip : 55042-4001
Country : US
Telephone Number : 651-238-7576
Fax Number :
Provider Business Practice Location Address
First Line : 6545 FRANCE AVE S STE 150
Second Line :
City : EDINA
State : MN
Zip : 55435-2180
Country : US
Telephone Number : 952-848-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2021
Last Update Date : 08/29/2022

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Directions to “ MICHAEL JAMES GREENSTEIN PA-C” Practice Location

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