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Organization
NEW HOPE CRYSTAL MEDICAL CLINIC
Active
Organization
NEW HOPE CRYSTAL MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ART FRETAG (BUSINESS 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
MN
01
—
2092
HEALTHPARTNERS
MN
01
—
30310462
METROPOLITAN HEALTH PLAN
MN
01
—
93495050569001
PREFERRED ONE
MN
01
—
97421NO
BLUES
MN
01
—
P044
UCARE
MN
Enumeration date
04/07/2006
Last updated
08/22/2020
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