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ADVANCED FOOT CARE CLINICLTD NPI 1053438648


NPI Information

NPI: 1053438648
Provider Name: ADVANCED FOOT CARE CLINIC,LTD

Doing Business As: ADVANCED FOOT & ANKLE CARE

Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
825 NICOLLET MALL
SUITE 601
MINNEAPOLIS, MN
ZIP 55402
Phone: (763) 550-1013
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ADVANCED FOOT CARE CLINIC,LTD is a podiatrist in Minneapolis, MN. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. ADVANCED FOOT CARE CLINIC,LTD NPI is 1053438648. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Foot & Ankle Care.

The provider's business location address is:

825 NICOLLET MALL
SUITE 601
MINNEAPOLIS, MN
ZIP 55402-606
Phone: (763) 550-1013
Fax: (763) 550-0615

The provider's authorized official is Robert Mullin .
The authorized official title is President and has the following contact phone number (763) 550-1013.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 3/4/2008.


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
1213E00000XPodiatrist507MINNESOTAYes

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
14724190001MEDICARE NSCMINNESOTA

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: 11/14/2023

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