| Fong Medical Clinic, Pa | |
|
105 New England Pl Suite 220 Stillwater MN 55082-5783 | |
| (651) 731-3664 | |
| (651) 430-9981 |
| Full Name | Fong Medical Clinic, Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 105 New England Pl, Stillwater, Minnesota |
| Authorized Official Name and Position | Milton Tan Fong (PRESIDENT) |
| Authorized Official Contact | 6517313664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fong Medical Clinic, Pa 105 New England Pl Suite 220 Stillwater MN 55082-5783 Ph: (651) 731-3664 | Fong Medical Clinic, Pa 105 New England Pl Suite 220 Stillwater MN 55082-5783 Ph: (651) 731-3664 |
| NPI Number | 1316043425 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316043425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 39331 (Minnesota) | Primary |
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