Organization
FAIRVIEW HEALTH SERVICES
Active
Other names
Fairview Lakes Regional Medical Center - Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN V RING (SYS DIR GOVT REIMB & NETWK REL)
(612) 672-6740
Entity
Organization
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7000
(651) 982-7110
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
(612) 672-6740
(612) 884-3592
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108418600
—
MN
01
—
121112
UCARE
MN
01
—
136674
UCARE
MN
01
—
51329
HEALTHPARTNERS
MN
01
—
51449
HEALTHPARTNERS
MN
01
—
52191CH
BCBS
MN
01
—
73769
HEALTHPARTNERS
MN
05
—
792825401
—
MN
05
—
806010000
—
MN
05
—
806010002
—
MN
05
—
806010003
—
MN
05
—
806010004
—
MN
01
—
FP905
PREFERREDONE
MN
Enumeration date
10/17/2006
Last updated
02/24/2025
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