Provider Demographics
NPI:1003894460
Name:SINICROPI, STEFANO M (MD)
Entity type:Individual
Prefix:
First Name:STEFANO
Middle Name:M
Last Name:SINICROPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1950 NORTHWESTERN AVE S STE 102
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-7615
Mailing Address - Country:US
Mailing Address - Phone:651-430-3800
Mailing Address - Fax:651-430-3827
Practice Address - Street 1:7373 FRANCE AVE S STE 408
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4549
Practice Address - Country:US
Practice Address - Phone:651-430-3800
Practice Address - Fax:651-430-1447
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48529207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0902456OtherMEDICA
MN79G21SIOtherBLUE CROSS BLUE SHIELD
WI34861400Medicaid
MN133254OtherUCARE
MN337150600Medicaid
MNHP63454OtherHEALTH PARTNERS
MN1047423OtherPREFERRED ONE
WI491750011Medicare PIN
I38346Medicare UPIN
MN200002466Medicare PIN
MN1047423OtherPREFERRED ONE