Organization
MIDWEST SPINE & BRAIN INSTITUTE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI OHLAND MHA, CMPE (ADMINISTRATOR)
(651) 430-3800
Entity
Organization
Contact information
Practice address
1950 NORTHWESTERN AVE S STE 102, STILLWATER, MN 55082-7615
(651) 430-3800
(651) 430-3827
Mailing address
1950 NORTHWESTERN AVE S STE 102, STILLWATER, MN 55082-7615
(651) 430-3800
(651) 430-3827
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0900009
MEDICA
MN
01
—
115117
UCARE
MN
01
—
1M559MI
BLUE CROSS & BLUE SHIELD
MN
05
—
32851500
—
WI
05
—
620529100
—
MN
01
—
96425
PREFERRED ONE
MN
01
—
HP10969
HEALTHPARTNERS
MN
01
—
N004668
CHAMPUS
MN
Enumeration date
07/04/2006
Last updated
03/15/2019
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