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NPI Code Detail

MEDICARE: CRAIG A SOLEM

MEDICARE: CRAIG A SOLEM
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
1207RG0100XGastroenterology Physician42756MN

General Provider Information

NPI Number : 1801873377
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG A SOLEM
Provider Business Mailing Address
First Line : PO BOX 14909
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-0909
Country : US
Telephone Number : 612-871-1145
Fax Number : 612-870-5491
Provider Business Practice Location Address
First Line : 1185 TOWN CENTRE DR STE 205
Second Line :
City : EAGAN
State : MN
Zip : 55123-1370
Country : US
Telephone Number : 612-871-1145
Fax Number : 612-870-5491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 12/09/2015

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Directions to “ CRAIG A SOLEM ” Practice Location

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