Organization
THE DULUTH CLINIC, LTD
Active
Parent organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
Other names
Duluth Clinic at Lakeview Medical Center Spooner Dialysis Unit
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
Authorized official
MICHAEL C METCALF (EVP)
(218) 786-2642
Entity
Organization
Contact information
Practice address
819 ASH ST, SPOONER, WI 54801-1201
(715) 635-5303
Mailing address
819 ASH ST, SPOONER, WI 54801-1201
(715) 635-5303
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
—
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D0040177
CLIA
WI
Enumeration date
04/20/2007
Last updated
04/09/2010
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