Individual
DR. ALISON RENE WAGENKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1835 W. CTY RD C, ROSEVILLE, MN 55113
(763) 785-4500
Mailing address
1835 W. CTY RD C, ROSEVILLE, MN 55113
(763) 785-4500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37558
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100730
MEDICA
MN
01
—
09F08WA
BCBS OF MN
MN
01
—
1011665
PREFERRED ONE
MN
01
—
106664
UCARE MN
MN
05
—
577314800
—
MN
01
—
5882147
AETNA INS
MN
01
—
6603819
MEDICA URGENT CARE
MN
01
—
88302
AMERICA'S PPO
MN
01
—
HP19980
HEALTHPARTNERS
MN
Enumeration date
08/31/2006
Last updated
02/10/2014
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