Provider Demographics
NPI:1417159187
Name:INTERNAL MEDICINE AND GERIATRICS ASSOCIATES
Entity Type:Organization
Organization Name:INTERNAL MEDICINE AND GERIATRICS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-732-4352
Mailing Address - Street 1:701 25TH AVE S
Mailing Address - Street 2:SUITE 505
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1513
Mailing Address - Country:US
Mailing Address - Phone:507-732-4352
Mailing Address - Fax:507-732-4736
Practice Address - Street 1:701 25TH AVE S
Practice Address - Street 2:SUITE 505
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1513
Practice Address - Country:US
Practice Address - Phone:507-732-4352
Practice Address - Fax:507-732-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty