PROACTIVE HEALTHCARE NPI 1891058384

NPI Information

PROACTIVE HEALTHCARE is a general practice in Saint Paul, 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 PROACTIVE HEALTHCARE NPI is 1891058384. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

101 5TH ST E
SUITE 227
SAINT PAUL, MN
ZIP 55101-898
Phone: (651) 778-0080
Fax: (651) 778-0195

The provider's authorized official is Nathan Burdash .
The authorized official title is C.e.o. and has the following contact phone number (651) 778-0080.

The enumeration date for this NPI number is 6/19/2012 and was last updated on 9/27/2012.

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:

Other Identifiers

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

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