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NPI Code Detail

MEDICARE: MINNESOTA ONCOLOGY HEMATOLOGY, PA

MEDICARE: MINNESOTA ONCOLOGY HEMATOLOGY, PA
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
1363AS0400XSurgical Physician Assistant1076MN
2364SA2200XAdult Health Clinical Nurse Specialist1076MN
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician1076MN

General Provider Information

NPI Number : 1851569909
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINNESOTA ONCOLOGY HEMATOLOGY, PA
Provider Business Mailing Address
First Line : 6363 FRANCE AVE S
Second Line : SUITE 200
City : EDINA
State : MN
Zip : 55435-2129
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Provider Business Practice Location Address
First Line : 6363 FRANCE AVE S
Second Line : SUITE 200
City : EDINA
State : MN
Zip : 55435-2129
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Authorized Official
Title or Position : SR. ADMINISTRATIVE ASSISTANT
Name : KATHRYN M THOMPSON
Credential :
Telephone Number : 651-602-5266
Provider Enumeration Date : 02/12/2008
Last Update Date : 02/12/2008

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