Provider Demographics
NPI:1245332170
Name:OPPEL, ANDREW DOUGLAS (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DOUGLAS
Last Name:OPPEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:13819 HANSON BLVD NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-7608
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-862-4490
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2012-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN9837363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN640928800Medicaid
MN2014138OtherAMERICA'S PPO
MNHP39726OtherHEALTHPARTNERS
MN272P7OPOtherBCBS OF MN
MN131065OtherUCARE MN
MN1040806OtherPREFERRED ONE
MN6608893OtherMEDICA URGENT CARE
MN272P7OPOtherBCBS OF MN
MN6608893OtherMEDICA URGENT CARE
MN640928800Medicaid