Provider Demographics
NPI:1083698286
Name:MOHS, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MOHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W MAIN
Mailing Address - Street 2:CENTRACARE CLINIC
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352
Mailing Address - Country:US
Mailing Address - Phone:320-256-4228
Mailing Address - Fax:320-256-7106
Practice Address - Street 1:525 W MAIN
Practice Address - Street 2:CENTRACARE CLINIC
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352
Practice Address - Country:US
Practice Address - Phone:320-256-4228
Practice Address - Fax:320-256-7106
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
938033OtherFIRST HEALTH PLAN
889002OtherPREFERRED ONE
HP17773OtherHEALTH PARTNERS
47A50MOOtherBLUE CROSS BLUE SHIELD
104100OtherMEDICA HEALTH PLANS
109968OtherU CARE
600839OtherARAZ GRP AMERICA'S PPO
109968OtherU CARE