Organization
CROWN MEDICAL SUPPORT SERVICES INC
Active
Other names
Crown Medical Support Services Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOYCE IHIOMA ONYEKABA M.D (MEDICAL DIRECTOR)
(612) 978-3783
Entity
Organization
Contact information
Practice address
1925 1ST AVE S, MINNEAPOLIS, MN 55403-3724
(612) 978-3783
(612) 872-4343
Mailing address
1925 1ST AVE S, MINNEAPOLIS, MN 55403-3724
(612) 978-3783
(612) 872-4343
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
36657
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
957449200
—
MN
Enumeration date
01/22/2016
Last updated
02/26/2024
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