Provider Demographics
NPI:1306812698
Name:MISCHEL, ANNE-MARIE M (MD)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:M
Last Name:MISCHEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1575 BEAM AVE
Mailing Address - Street 2:ST JOHN'S HOSPITAL MEDICINE DEPARTMENT
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1126
Mailing Address - Country:US
Mailing Address - Phone:651-326-7200
Mailing Address - Fax:651-326-7240
Practice Address - Street 1:1575 BEAM AVE
Practice Address - Street 2:ST JOHN'S HOSPITAL MEDICINE DEPARTMENT
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1126
Practice Address - Country:US
Practice Address - Phone:651-326-7200
Practice Address - Fax:651-326-7240
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-04-03
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Provider Licenses
StateLicense IDTaxonomies
MN43733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN043702600Medicaid
H51783Medicare UPIN
MN043702600Medicaid