Individual
ANDREW JAMES MISSELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3700
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
48706
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1047281
PREFERRED ONE
MN
01
—
133246
UCARE
—
01
—
1604206
MEDICA
MN
01
—
1770500555
AMERICA'S PPO
MN
01
—
300003980
MEDICARE
MN
01
—
300003981
MEDICARE
MN
01
—
814T2MI
BLUE CROSS BLUE SHIELD
MN
05
—
872600100
—
MN
01
—
HP65836
HEALTHPARTNERS
MN
01
—
P00332886
RAILROAD MEDICARE
MN
Enumeration date
07/16/2006
Last updated
06/10/2021
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