Organization
MINNESOTA SPINE REHAB, INC
Active
Other names
Specialists in Occupational & Envrionmental Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERIEF A MIKHAIL M.D., M.P.H. (MEDICAL DIRECTOR)
(651) 209-6520
Entity
Organization
Contact information
Practice address
360 SHERMAN ST, SUITE 470, SAINT PAUL, MN 55102-2564
(651) 209-6520
(651) 209-6521
Mailing address
360 SHERMAN ST, SUITE 470, SAINT PAUL, MN 55102-2564
(651) 209-6520
(651) 209-6521
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
33701
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306C
CHOICE PLUS GROUP NUMBER
—
01
—
47D55MI
BCBS OF MN CLINIC NUMBER
FM
01
—
509491027972
PREFERRED ONE GROUP NUMBE
MN
01
—
79737
HEALTH PARTNERS GROUP NUM
FM
01
—
9800099
MEDICA GROUP NUMBER
FM
01
—
A001
TRICARE GROUP NUMBER
MN
01
—
F703
UCARE GROUP NUMBER
MN
Enumeration date
07/14/2006
Last updated
12/18/2007
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