Organization
ST. PAUL FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHUA XIONG MD (PRESIDENT)
(651) 209-8350
Entity
Organization
Contact information
Practice address
1239 PAYNE AVE, SAINT PAUL, MN 55130
(651) 209-8350
Mailing address
1239 PAYNE AVE, SAINT PAUL, MN 55130
(651) 209-8350
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1571
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-09122
MEDICA
MN
01
—
156J3ST
BLUE CROSS BLUE SHIELD
MN
01
—
170453
UCARE MINNESOTA
MN
05
—
489369700
—
MN
01
—
83934
HEALTHPARTNERS
MN
01
—
G174
PATIENT CHOICE
MN
Enumeration date
12/13/2006
Last updated
10/17/2016
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