Midway Family Clinic Pa

NPI 1114988805 - Family Medicine - 207Q00000X

NPI Details
NPI 1114988805
Enumeration Date 03/31/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name YOHANNES YOHANNES
Position PRESIDENT
Phone (651) 644-2273
Fax (651) 659-2273
Practice Location
1821 UNIVERSITY AVE W
SUITE S-206
SAINT PAUL MN, 55104-2801, US
Phone (651) 644-2273
Fax (651) 659-2273
Business Location
1821 UNIVERSITY AVE W
SUITE S-206
SAINT PAUL MN, 55104-2801, US
Phone (651) 644-2273
Fax (651) 659-2273
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
Remove 1114988805 NPI Number
 

According to our database, Midway Family Clinic Pa NPI is 1114988805, taxonomy code is 207Q00000X Midway Family Clinic Pa physically located at 1821 University Ave W, Saint Paul MN, 55104-2801. NPI Number 1033115704 has the healthcare provider type.

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1114988805 NPI number is provided on an as is basis without warranty of any kind. 1114988805 is maintained by the National Plan & Provider Enumeration System. The contents of Midway Family Clinic Pa are for informational purposes only.