Organization · Type 2 NPI

Pediatric and Young Adult Medicine, PA

Primary Care Clinic/Center · Lake Elmo, MN

NPI number 1457593550 Active

Practice location

8650 Hudson Blvd N, Suite 125
Lake Elmo, MN 55042-9747

Call (651) 256-6706 Map

Fax (651) 256-6707

Mailing address

1804 7th St W, Suite 200
St. Paul, MN 55116-2300

Specialties and licenses

TaxonomyCodeLicense
Primary Care Clinic/Center Primary 261QP2300X154 (MN)

Primary Care Clinic/Center: Definition to come...

28 other providers at this address

About NPI 1457593550

Pediatric and Young Adult Medicine, PA's National Provider Identifier is 1457593550, issued on Apr 3, 2009. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Lake Elmo, MN. The record was last updated on Dec 7, 2016.