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Contact Information

CENTRAL MEDICAL CLINIC LLC
393 N DUNLAP STREET
SUITE LL34
SAINT PAUL, MN55104
 Phone: 651-644-6002
 Fax: 651-644-2048
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Clinic/Center

261Q00000X
Indicates primary specialty

NPI Profile & details for CENTRAL MEDICAL CLINIC LLC · (Female)

NPI # 1437313434
Status Active
Credentials
Entity Individual
Enumeration date 07/18/2008
Last updated 07/18/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 37899
  • MN Medicaid 2168900
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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