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Organization
PEDIATRIC ENT ASSOCIATES
Active
Organization
PEDIATRIC ENT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA A HEIMERL (MANAGER)
(612) 874-1292
Entity
Organization
Contact information
Practice address
910 E 26TH ST, SUITE 323, MINNEAPOLIS, MN 55404-4526
(612) 874-1292
Mailing address
910 E 26TH ST, SUITE 323, MINNEAPOLIS, MN 55404-4526
(612) 874-1292
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
NULL
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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