Organization
MINNESOTA MICRO MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY LANG SEIFERT M.D. (OWNER)
(952) 474-0434
Entity
Organization
Contact information
Practice address
19245 HIGHWAY 7, EXCELSIOR, MN 55331-9126
(952) 474-0434
(952) 474-0491
Mailing address
19245 HIGHWAY 7, EXCELSIOR, MN 55331-9126
(952) 474-0434
(952) 474-0491
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
16429
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080006598
—
MN
05
—
569062500
—
MN
Enumeration date
05/29/2008
Last updated
05/29/2008
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