DR. SAMUEL BLAKE ECKER (NPI# 1033555230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033555230 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL BLAKE ECKER |
| Credential | D.O. |
| Practice Address |
3655 Plymouth Blvd Ste 110 Minneapolis MN 55446-3665 |
| Practice Telephone | (612) 486-4200 |
| Practice Fax Number | 6124864201 |
| Mailing Telephone | (612) 486-4200 |
| Mailing Fax Number | 6124864201 |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 59682 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7031 Sw 62nd Ave, South Miami, FL 331434701 | 3052867761 | 3052847787 |
| Street Address |
3655 PLYMOUTH BLVD STE 110 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55446-3665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114552379 | Molly M Mahoney | Pharmacist | 4110 Juneau Lane N, Plymouth, MN 55446 | 2020-03-09 |
| 1073064804 | Owen Payne Kusick | Student in an Organized Health Care Education/Training Program | 16717 49th Pl N, Plymouth, MN 55446 | 2016-10-17 |
| 1043696214 | Kari Shoemaker | Speech-Language Pathologist | 5855 Cheshire Parkway, Plymouth, MN 55446 | 2015-08-10 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1851715163 | Group Health Plan Inc | Clinic/Center | 5000 Fernbrook Ln N, Plymouth, MN 55446 | 2014-02-06 |
| 1588903009 | Laura Davidson | Physician Assistant | 3365 Plymouth Blvd., Suite 110, Plymouth, MN 55446 | 2013-02-04 |
| 1366680688 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6025 Shenandoah Ln N, Plymouth, MN 55446 | 2009-01-23 |
| 1205046646 | Merida A Miller | Obstetrics & Gynecology | 4155 Cty Rd 101 N, Plymouth, MN 55446 | 2007-05-23 |
| 1376684746 | West Metro Ophthalmology, Pa | Ophthalmology | 15655 37th Ave N Ste 200, Plymouth, MN 55446 | 2007-02-09 |
| 1952401390 | Grand St Paul Cvs LLC | Pharmacy | 4140 Rd 101 N, Plymouth, MN 55446 | 2006-09-25 |
| Find all providers in zip 55446 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578982773 | Lori Ann Fiessinger | Dermatology | 420 Delaware Street Se, Mmc 98, Minneapolis, MN 55455 | 2014-04-15 |
| 1295078913 | Jessica Jane Newman | Dermatology | 4-240, Phillips-wangensteen Bldg., 516 Delaware Street S.e., Mail Code 98, Minneapolis, MN 55455 | 2013-04-01 |
| 1124317383 | Sara Anne Hylwa | Dermatology | 730 South 8th Street, Department of Dermatology, Minneapolis, MN 55415 | 2011-03-28 |
| 1922328418 | Craig Thomas Roelke | Dermatology | 2603 39th Ave Ne, Suite D-202, Minneapolis, MN 55421-4372 | 2010-06-07 |
| 1063731065 | Margareth Pierre-louis | Dermatology | 5000 W 36th St Ste 205, Minneapolis, MN 55416-2760 | 2010-05-31 |
| 1205841715 | Lynda Sue Kauls | Dermatology | 275 Market St, Suite 215, Minneapolis, MN 55405-1627 | 2006-07-31 |
| 1437178811 | John Bergman | Dermatology | 825 Nicollet Mall Ste 1227, Minneapolis, MN 55402-2702 | 2006-07-18 |
| 1134152218 | Maria Kramarczuk Hordinsky | Dermatology | 516 Delaware Street Se, Clinic 5a, Dermatology Clinic, Minneapolis, MN 55455-0356 | 2006-07-09 |
| 1316986268 | Lynn Glesne | Dermatology | 1425 10th Ave S, Minneapolis, MN 55404-1309 | 2006-06-06 |
| 1710951199 | Alexia P Knapp | Dermatology | 2220 Riverside Ave - Mail Stop 31700a, Healthpartners Riverside Clinic, Minneapolis, MN 55454-1321 | 2006-02-14 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55446 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.