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Individual

MAIRE BRID MACBRIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MBBCH

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(508) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(508) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
038546
MN
207R00000X
Internal Medicine Physician
Primary
38546
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
237823000
MN
05
35235200
WI
05
ENROLLED
IA
01
P00937244
RAILROAD MEDICARE
MN
Enumeration date
05/17/2006
Last updated
08/12/2011
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