Individual
GREGORY M VERCELLOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
424 HARVARD STREET SE, MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414-2924
(612) 884-0649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25121
MN
207RH0003X
Hematology & Oncology Physician
Primary
25121
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090100
FAIRVIEW
MN
01
—
100794
UCARE
MN
01
—
1009342
PREFERREDONE
MN
01
—
2T188VE
BLUE CROSS BLUE SHIELD
MN
01
—
3624552
MEDICA - CHOICE
MN
01
—
3674562
MEDICA - PRIMARY
MN
01
—
525815
ARAZ
MN
05
—
927205400
—
MN
01
—
HP22082
HEALTHPARTNERS
MN
Enumeration date
09/25/2006
Last updated
12/01/2014
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