MINNEAPOLIS INTEGRATIVE MEDICINE CENTER LLC NPI 1447857230

NPI Information

  • NPI: 1447857230
  • Provider Name: MINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • CLIA Number: 24D2171701
  • Address: 1120 WAYZATA BLVD E STE 110
    WAYZATA, MN
    ZIP 55391
  • Phone: (952) 222-7670

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NPI Details

MINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC is a general practice in Wayzata, MN. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC NPI is 1447857230. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1120 WAYZATA BLVD E STE 110
WAYZATA, MN
ZIP 55391-984
Phone: (952) 222-7670
Fax: (763) 210-6809

The provider's authorized official is Cassandra Wilder .
The authorized official title is Owner and has the following contact phone number (952) 222-7670.

The CLIA number assigned to this NPI record is 24D2171701 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/5/2020 and was last updated on 5/8/2024.

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
1208D00000XGeneral PracticeYes

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: 3/30/2025

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