Bethke, Lori Marie

Bethke, Lori Marie is an individual health care provider with primary practice located at 3550 Labore Rd Ste 7 , Vadnais Heights MN 55110-5113. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bethke, Lori Marie can be contacted via phone (651) 766-0520.

Contact Information

Primary practice address
3550 Labore Rd Ste 7 Vadnais Heights MN 55110-5113
Phone: (651) 766-0520
Fax: (651) 766-9451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 43604 Minnesota

Profile Details

NPI number 1639193261
LBN Legal business name Bethke, Lori Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Apr 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639193261 NPPES
Minnesota MEDICAID 754463400

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