Organization
MIDWEST CLINIC OF DERMATOLOGY LASER AND COSMETIC SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL KEVIN ELIEFF MD (PRESIDENT/OWNER)
(320) 259-0208
Entity
Organization
Contact information
Practice address
1510 24TH AVE N, SAINT CLOUD, MN 56303-1304
(320) 259-0208
(320) 259-0715
Mailing address
1510 24TH AVE N, SAINT CLOUD, MN 56303-1304
(320) 259-0208
(320) 259-0715
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
09/13/2006
Last updated
10/02/2014
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