Organization
CRYSTAL NEW HOPE MEDICAL CLINIC INC
Active
Other names
NEW HOPE CRYSTAL MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE M URBASHICH (OFFICE MANAGER)
(763) 535-9601
Entity
Organization
Contact information
Practice address
3501 DOUGLAS DR N, CRYSTAL, MN 55422-2415
(763) 535-9601
(763) 535-5601
Mailing address
3501 DOUGLAS DR N, CRYSTAL, MN 55422-2415
(763) 535-9601
(763) 535-5601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005733572
AETNA
—
01
—
085N8NE
BLUES
—
05
—
442672100
—
MN
01
—
P044
UCARE
—
Enumeration date
01/17/2008
Last updated
01/08/2013
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