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ST. CLOUD EAR NOSE & THROAT CLINIC P.A. NPI 1508882754


NPI Information

NPI: 1508882754
Provider Name: ST. CLOUD EAR, NOSE & THROAT CLINIC, P.A.

Other Name: ST. CLOUD EAR, NOSE & THROAT - HEAD & NECK CLINIC

Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 24D0405700

Address:
1528 NORTHWAY DR
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 252-0233
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ST. CLOUD EAR, NOSE & THROAT CLINIC, P.A. is an otolaryngology in Saint Cloud, MN. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. ST. CLOUD EAR, NOSE & THROAT CLINIC, P.A. NPI is 1508882754. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is St. Cloud Ear, Nose & Throat - Head & Neck Clinic.

The provider's business location address is:

1528 NORTHWAY DR
SAINT CLOUD, MN
ZIP 56303-255
Phone: (320) 252-0233

The provider's authorized official is Amanda Rae Ressemann .
The authorized official title is Business Office Manager and has the following contact phone number (320) 257-1167.

The CLIA number assigned to this NPI record is 24D0405700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 2/2/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
155319CLOTHERMINNESOTABLUE CROSS BLUE SHIELD
2508208100MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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