Organization
PREMIER OBGYN OF MINNESOTA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE ANDERSON (SR MGR CRED IMPL AND PROVIDER SERV)
(561) 486-8439
Entity
Organization
Contact information
Practice address
3625 W. 65TH STREET, SUITE 100, EDINA, MN 55435
(952) 920-7001
(952) 345-0472
Mailing address
3625 W. 65TH STREET, SUITE 100, EDINA, MN 55435
(952) 920-7001
(952) 345-0472
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
005416
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
755010300
—
MN
Enumeration date
01/10/2007
Last updated
03/21/2022
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