Organization
MINA MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IDIRIS ESSE MD (MEDICAL DIRECTOR)
(612) 274-4380
Entity
Organization
Contact information
Practice address
1690 SILVER LAKE ROAD NW, NEW BRIGHTON, MN 55112
(612) 274-4380
Mailing address
6417 PENN AVE S STE 8, MINNEAPOLIS, MN 55423-1196
(612) 274-4380
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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