Columbia Park Medical Group, PA

NPI #1932150117 in Fridley, Minnesota

Provider Information

NPI Number: 1932150117
Entity Type: Organization
Organization Name: Columbia Park Medical Group, PA
Primary Specialty: Family Medicine
Enumeration Date: May 13, 2006
Last Updated: Nov 13, 2007

Practice Location

Address: 6401 UNIVERSITY AVE NE
Address 2: SUITE 200
City: Fridley
State: Minnesota
ZIP Code: 55432-4341
Phone: (763) 572-5710

Authorized Official

Name: JOEN V CONDON
Title: CHIEF FINANCIAL OFFICER
Phone: (763) 586-5839

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X
Allergy & Immunology	207K00000X
Internal Medicine	207R00000X
Internal Medicine - Endocrinology, Diabetes & Metabolism — Endocrinology, Diabetes & Metabolism	207RE0101X
Internal Medicine - Infectious Disease — Infectious Disease	207RI0200X
Obstetrics & Gynecology	207V00000X
Ophthalmology	207W00000X
Orthopaedic Surgery	207X00000X
Otolaryngology	207Y00000X
Pediatrics	208000000X
Preventive Medicine - Occupational Medicine — Occupational Medicine	2083X0100X
Surgery	208600000X
Urology	208800000X
Hospitalist	208M00000X
Family Medicine	207Q00000X	Primary

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