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NPI Profile for LIFESPARK MEDICAL GROUP PA in SAINT LOUIS PARK, MN.
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Geriatric Medicine |
207QG0300X | 08 | Physician/Family Practice | |
Adult Health |
363LA2200X | 50 | Nurse Practitioner | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Geriatric Medicine |
207RG0300X | 11 | Physician/Internal Medicine | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1427551746 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/13/2018 | |
| Last updated | 05/02/2022 - About 4 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LIFESPARK MEDICAL GROUP, PA
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LIFESPARK MEDICAL GROUP, PA