Provider Demographics
NPI:1548236508
Name:WINTERS, PATRICIA M (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:WINTERS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8401 GOLDEN VALLEY RD STE 330
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4488
Mailing Address - Country:US
Mailing Address - Phone:763-416-7629
Mailing Address - Fax:763-383-4147
Practice Address - Street 1:250 CENTRAL AVE N STE 105
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391
Practice Address - Country:US
Practice Address - Phone:763-416-7600
Practice Address - Fax:952-475-2406
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-03-18
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Provider Licenses
StateLicense IDTaxonomies
MN2890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66675Medicare UPIN