Organization
CENTRACARE CLINIC
Active
Parent organization
CENTRACARE CLINIC
Other names
CentraCare - Urology Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRACARE CLINIC
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
2351 CONNECTICUT AVE S, SUITE 200, CENTRACARE CLINIC- ADULT & PEDIATRIC UROLOGY, SARTELL, MN 56377-2477
(320) 259-1411
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 259-1411
(320) 259-8967
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
06/23/2025
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