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Organization
CRYSTAL NEW HOPE MEDICAL CLINIC INC
Active
Organization
CRYSTAL NEW HOPE MEDICAL CLINIC INC
Active
Other names
NEW HOPE CRYSTAL MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE M URBASHICH (OFFICE MANAGER)
(763) 535-9601
Entity
Organization
Contact information
Practice address
3501 DOUGLAS DR N, CRYSTAL, MN 55422-2415
(763) 535-9601
(763) 535-5601
Mailing address
3501 DOUGLAS DR N, CRYSTAL, MN 55422-2415
(763) 535-9601
(763) 535-5601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005733572
AETNA
—
01
—
085N8NE
BLUES
—
05
—
442672100
—
MN
01
—
P044
UCARE
—
Enumeration date
01/17/2008
Last updated
01/08/2013
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