DERMATOLOGY PROFESSIONALS PA NPI 1306196548

NPI Information

  • NPI: 1306196548
  • Provider Name: DERMATOLOGY PROFESSIONALS PA
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • CLIA Number: 24D2047643
  • Address: 15167 EDGEWOOD DR
    SUITE 200
    BAXTER, MN
    ZIP 56401
  • Phone: (218) 454-7546

Map and Directions

Get Directions

NPI Details

DERMATOLOGY PROFESSIONALS PA is a clinic center in Baxter, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DERMATOLOGY PROFESSIONALS PA NPI is 1306196548. The provider is registered as an organization entity type.

The provider's business location address is:

15167 EDGEWOOD DR
SUITE 200
BAXTER, MN
ZIP 56401-946
Phone: (218) 454-7546

The provider's authorized official is Morgan Burgstaler .
The authorized official title is Administrator and has the following contact phone number (218) 454-3065.

The CLIA number assigned to this NPI record is 24D2047643 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/14/2012 and was last updated on 6/12/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center45453MINNESOTAYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI