Provider Demographics
NPI:1164787784
Name:ACCESS MEDICAL
Entity Type:Organization
Organization Name:ACCESS MEDICAL
Other - Org Name:ACCESS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:TRITES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:320-333-0896
Mailing Address - Street 1:2200 W 66TH ST
Mailing Address - Street 2:SUITE 199
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2131
Mailing Address - Country:US
Mailing Address - Phone:320-333-0896
Mailing Address - Fax:888-582-8339
Practice Address - Street 1:2200 W 66TH ST
Practice Address - Street 2:SUITE 199
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2131
Practice Address - Country:US
Practice Address - Phone:320-333-0896
Practice Address - Fax:888-582-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN260854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty