Organization
CONRAD L MEINTS & ASSOCIATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LYNN SODERHOLM (OFFICE MANAGER)
(218) 722-0326
Entity
Organization
Contact information
Practice address
324 W SUPERIOR ST, SUITE 517, DULUTH, MN 55802-1760
(218) 722-0626
(218) 722-4403
Mailing address
324 W SUPERIOR ST, SUITE 517, DULUTH, MN 55802-1760
(218) 722-0626
(218) 722-4403
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
532
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2700690
MEDICA
MN
01
—
480034106
PALMETTO GBA RAILROAD MEDICARE
MN
05
—
767218700
—
MN
01
—
77342ME
BLUE CROSS BLUE SHIELD OF MINNESOTA
MN
Enumeration date
06/29/2009
Last updated
06/29/2009
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