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NPI Code Detail

MEDICARE: PHILLIP CLAIRE LINDHOLM M.D.

MEDICARE: PHILLIP CLAIRE LINDHOLM M.D.
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
1207R00000XInternal Medicine Physician0101250823VA
2207RG0100XGastroenterology Physician0101250823VA

General Provider Information

NPI Number : 1932411147
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP CLAIRE LINDHOLM M.D.
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 : 9145 SPRINGBROOK DR NW STE 200
Second Line :
City : COON RAPIDS
State : MN
Zip : 55433-5886
Country : US
Telephone Number : 612-871-1145
Fax Number : 612-870-5491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2010
Last Update Date : 08/09/2021

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