Organization
SKIN CARE DOCTORS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J EBERTZ M.D. (PRESIDENT)
(952) 898-1600
Entity
Organization
Contact information
Practice address
14000 NICOLLET AVE STE 304, BURNSVILLE, MN 55337-5784
(952) 898-1600
(952) 898-2645
Mailing address
14000 NICOLLET AVE STE 304, BURNSVILLE, MN 55337-5784
(952) 898-1600
(952) 898-2645
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09G0SK
BLUE CROSS BLUE SHIELD
MN
01
—
57238
HEALTH PARTNERS
MN
01
—
C02848
MEDICARE PTAN
MN
01
—
CH6529
RAILROAD MEDICARE
MN
01
—
E180
UCARE
MN
Enumeration date
04/17/2007
Last updated
07/15/2013
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