Organization
GREAT PLANES REPRODUCTIVE CENTER, P.A.
Active
Organization
GREAT PLANES REPRODUCTIVE CENTER, P.A.
Active
Parent organization
THE MIDWEST CENTER FOR REPRODUCTIVE HEALTH, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MIDWEST CENTER FOR REPRODUCTIVE HEALTH, P.A.
Authorized official
DR. RANDLE S CORFMAN PH.D, M.D. (MEDICAL DIRECTOR/OWNER)
(763) 494-7700
Entity
Organization
Contact information
Practice address
12000 ELM CREEK BLVD N, SUITE 350, MAPLE GROVE, MN 55369-7073
(763) 494-7700
(763) 494-7706
Mailing address
12000 ELM CREEK BLVD N, SUITE 350, MAPLE GROVE, MN 55369-7073
(763) 494-7700
(763) 494-7706
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3D491MI
BCBS-MN PROVIDER FACILITY
MN
01
—
3D492
BCBS-MN PROVIDER
MN
01
—
COR16153
BCBC-ND PROVIDER
MN
01
—
COR16154
BCBS-ND PROVIDER
MN
01
—
E02458
UPIN
MN
Enumeration date
08/06/2009
Last updated
08/06/2009
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