Provider Demographics
NPI:1275423550
Name:MINNESOTA ONCOLOGY HEMATOLOGY, PA
Entity type:Organization
Organization Name:MINNESOTA ONCOLOGY HEMATOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRED COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-602-5309
Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-8693
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:
Practice Address - Street 1:675 E NICOLLET BLVD STE 135
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6770
Practice Address - Country:US
Practice Address - Phone:651-312-1700
Practice Address - Fax:952-314-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty