Organization · Type 2 NPI

Columbia Park Medical Group, PA

Multi-Specialty Clinic/Center · Andover, MN

NPI number 1639274160 Active

Practice location

13819 Hanson Blvd NW
Andover, MN 55304-7608

Call (763) 572-5710 Map

Fax (763) 862-4415

Mailing address

6401 University Ave NE
Fridley, MN 55432-4341

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	None listed

Multi-Specialty Clinic/Center: Definition to come...

35 other providers at this address

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NPI record

NPI: 1639274160
Entity type: Organization (Type 2)
Issued: Sep 13, 2006
Last updated: Nov 13, 2007
Status: Active
Subpart: Yes of Columbia Park Medical Group, PA

Other names

<unavail>
Cpmg-Andover Park Clinic · other name

Authorized official

Joen V Condon
Chief Financial Officer
(763) 586-5839

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639274160

Columbia Park Medical Group, PA's National Provider Identifier is 1639274160, issued on Sep 13, 2006. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Andover, MN. The record was last updated on Nov 13, 2007.