Itasca Surgical Clinic, Pa

LBN: Itasca Surgical Clinic, Pa
Itasca Surgical Clinic, Pa is an health care organization with primary practice located at 1542 Golf Course Rd Suite 202, Grand Rapids MN 55744-9603. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Itasca Surgical Clinic, Pa can be contacted via phone (218) 327-7973, or through Margo, Daniel via phone (218) 327-7973.

Contact Information

Primary practice address
1542 Golf Course Rd Suite 202 Grand Rapids MN 55744-9603
Phone: (218) 327-7973
Fax: (218) 327-3245
Website:
Map and Directions
Authorized official contact:
Name: Margo, Daniel Doctor of Medicine (MD)
Phone: (218) 327-7973

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1245288984
LBN Legal business name Itasca Surgical Clinic, Pa
DBA Doing business as
Authorized official Margo, Daniel Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2006
Last updated Jul 9th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245288984 NPPES
Minnesota MEDICAID 448327800
Minnesota Other 97B18IT

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