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Contact Information

ROSEAU/WARROAD EYE CLINIC, P.A.
301 LAKE STREET NE
WARROAD, MN56763
 Phone: 218-386-2081
 Fax: 218-386-1217
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ROSEAUWARROAD EYE CLINIC PA · (Female)

NPI # 1861562340
Status Active
Credentials
Entity Individual
Enumeration date 11/09/2006
Last updated 08/05/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # #1693
  • MN License # 1618
  • MN License # 1693
  • MN License # 2946
  • MN Medicaid 275823700
  • MN Other 14000DI BLUE CROSS BLUE SHIELD
  • MN Other 14023ER BLUE CROSS BLUE SHIELD
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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