Individual
MARIA LYDIA PATACSIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
48187
MN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
48187
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0407936
MEDICA
MN
01
—
2392827
AMERICA'S PPO
MN
01
—
378G2PA
BLUE SHIELD
MN
05
—
444763800
—
MN
01
—
A031
CHAMPUS
MN
01
—
HP57349
HEALTH PARTNERS
MN
Enumeration date
01/27/2006
Last updated
01/17/2014
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