Organization
AFFILIATED FOOT AND ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W CHEESEBRO DPM (PRESIDENT)
(763) 383-8808
Entity
Organization
Contact information
Practice address
2805 CAMPUS DR STE 225, PLYMOUTH, MN 55441-2678
(763) 383-8808
(763) 383-6033
Mailing address
2805 CAMPUS DR #225, PLYMOUTH, MN 55441
(763) 383-8808
(763) 383-6033
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
366
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11691MI
BC/BS PROVIDER ID
MN
01
—
27-15055
MEDICA PROVIDER ID
MN
01
—
HP13053
HEALTHPARTNES PROV ID
MN
Enumeration date
09/20/2006
Last updated
08/22/2020
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