| NPI | 1558350488 |
|---|---|
| Former Legal Business Name | STILLWATER MEDICAL GROUP, PA |
| Entity Type | Organization |
| Authorized Contact | KIRK NYBAKKEN Director Of Finance 651-275-3302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207QS0010X Family Medicine Sports Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 2083X0100X Preventive Medicine Occupational Medicine | |
| 208600000X Surgery | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 231H00000X Audiologist | |
| 363AM0700X Physician Assistant Medical | |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2011-10-18 |