ST CLOUD MEDICAL GROUP PA NPI 1487690996

NPI Information

NPI: 1487690996
Provider Name: ST CLOUD MEDICAL GROUP PA
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
251 COUNTY ROAD 120
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 202-8949
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ST CLOUD MEDICAL GROUP PA is a multi-specialty clinic center in Saint Cloud, MN. ST CLOUD MEDICAL GROUP PA NPI is 1487690996. The provider is registered as an organization entity type.

The provider's business location address is:

251 COUNTY ROAD 120
SAINT CLOUD, MN
ZIP 56303-872
Phone: (320) 202-8949
Fax: (320) 202-0756

The provider's authorized official is Christopher Tacl .
The authorized official title is Medical Director and has the following contact phone number (320) 202-8949.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 10/6/2011.

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
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0522400001	MEDICARE NSC	MINNESOTA
2	175710500	MEDICAID	MINNESOTA
3	C07627	MEDICARE PIN	MINNESOTA

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

NPI Synchronization or Removal

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