Basic Information
Provider Information
NPI: 1154383404
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BINSFELD
FirstName: ELISE
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6341 UNIVERSITY AVE NE
Address2:  
City: FRIDLEY
State: MN
PostalCode: 554324946
CountryCode: US
TelephoneNumber: 7635725710
FaxNumber: 7635713008
Practice Location
Address1: 6341 UNIVERSITY AVE NE
Address2:  
City: FRIDLEY
State: MN
PostalCode: 554324946
CountryCode: US
TelephoneNumber: 7635725710
FaxNumber: 7635713008
Other Information
ProviderEnumerationDate: 04/03/2006
LastUpdateDate: 03/12/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X43605MNY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
HP3869901MNHEALTHPARTNERSOTHER
12015810005MN MEDICAID
660665101MNMEDICA UCOTHER
103438901MNPREFERRED ONEOTHER
16914601MNUCARE MNOTHER
188037001MNAMERICA'S PPOOTHER
011398601MNMEDICAOTHER
082K1BI01MNBCBS OF MNOTHER
708452801MNAETNAOTHER


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