Organization
ST PAUL INTERNAL MEDICINE
Active
Other names
St Peter Street Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH A SLATTERY MD (DOCTOR/OWNER)
(651) 645-9600
Entity
Organization
Contact information
Practice address
514 ST PETER STREET, SUITE 250, ST PAUL, MN 55102
(651) 645-9600
(651) 645-9605
Mailing address
6200 SHINGLE CREEK PKWY, SUITE 300, BROOKLYN CENTER, MN 55430-2128
(763) 561-5986
(763) 561-6280
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31392
MN
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0409583
MEDICA
MN
01
—
10N38ST
BCBS
MN
05
—
938088400
—
MN
05
—
948448000
—
MN
01
—
DF1694
RAILROAD MEDICARE
MN
Enumeration date
10/03/2006
Last updated
07/18/2008
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