Individual
DR. MONA S.I. ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1285 NININGER RD, HASTINGS, MN 55033-1086
(651) 480-4200
(651) 480-4306
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40336
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-02679
MEDICA
MN
01
—
080004370
RAILROAD MEDICARE
MN
01
—
11R00R0
BLUE CROSS
MN
01
—
120927
UCARE MINNESOTA
MN
01
—
32397200
GROUP HEALTH EAU CLAIRE
MN
05
—
32397200
—
WI
01
—
66-02253
MEDICA URGENT CARE
MN
01
—
764806
AMERICAS PPO
MN
05
—
833224000
—
MN
01
—
HP23823
HEALTHPARTNERS
MN
01
—
NA9141014618
PREFERRED ONE
MN
Enumeration date
03/16/2006
Last updated
03/11/2021
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