Midway Medical Clinic Steven P. Radjenovich D.o. Llc | |
119 30th Ave W Alexandria MN 56308-3433 | |
(320) 763-6452 | |
(320) 763-2971 |
Full Name | Midway Medical Clinic Steven P. Radjenovich D.o. Llc |
---|---|
Speciality | Family Medicine |
Location | 119 30th Ave W, Alexandria, Minnesota |
Authorized Official Name and Position | Steven Perl Radjenovich (PRESIDENT) |
Authorized Official Contact | 3207636452 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Midway Medical Clinic Steven P. Radjenovich D.o. Llc 119 30th Ave W Alexandria MN 56308-3433 Ph: (320) 763-6452 | Midway Medical Clinic Steven P. Radjenovich D.o. Llc 119 30th Ave W Alexandria MN 56308-3433 Ph: (320) 763-6452 |
NPI Number | 1184610974 |
---|---|
Provider Enumeration Date | 09/27/2005 |
Last Update Date | 01/31/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184610974 | NPI | - | NPPES |
449883600 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 22233 (Minnesota) | Primary |
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