MEDICARE: KAREN K MASCHKA ROPA

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	363AS0400X	Surgical Physician Assistant	8957	MN

General Provider Information

NPI Number	:	1942421714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN K MASCHKA ROPA

Provider Business Mailing Address
First Line	:	PO BOX 86 SDS 12 2901
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-2901
Country	:	US
Telephone Number	:	651-968-5050
Fax Number	:	651-968-5900

Provider Business Practice Location Address
First Line	:	17 EXCHANGE ST W STE 307
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-1223
Country	:	US
Telephone Number	:	651-842-5200
Fax Number	:	651-223-5903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/26/2009

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