Basic Information
| Provider Information | |||||||||
| NPI: | 1871576116 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OBSTETRICS AND GYNECOLOGY ASSOCIATES, P.A. | ||||||||
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| OtherOrganizationName: | OBSTETRICS AND GYNECOLOGY SPECIALISTS AND ASSOCIATES IN WOMEN'S HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6517 DREW AVE S | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528419490 | ||||||||
| FaxNumber: | 9528069741 | ||||||||
| Practice Location | |||||||||
| Address1: | 6545 FRANCE AVE S | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529202200 | ||||||||
| FaxNumber: | 9529200866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2005 | ||||||||
| LastUpdateDate: | 02/06/2008 | ||||||||
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| AuthorizedOfficialLastName: | KAMIN | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9529248668 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.