Provider Demographics
NPI:1497157358
Name:MINNESOTA MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:MINNESOTA MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-354-3360
Mailing Address - Street 1:715 FLORIDA AVE S
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1719
Mailing Address - Country:US
Mailing Address - Phone:612-354-3360
Mailing Address - Fax:612-315-4165
Practice Address - Street 1:715 FLORIDA AVE S
Practice Address - Street 2:SUITE 205
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1719
Practice Address - Country:US
Practice Address - Phone:612-354-3360
Practice Address - Fax:612-315-4165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty