PAMELA KOLACZ (NPI# 1205852480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205852480 |
| Entity Type | Individual |
| Full Name | PAMELA KOLACZ |
| Credential | M.D. |
| Practice Address |
6320 Wedgwood Rd N Maple Grove MN 55311-3647 |
| Practice Telephone | 7632680400 |
| Practice Fax Number | 7632680405 |
| Mailing Telephone | 7632680400 |
| Mailing Fax Number | 7632680405 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2012-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 42205 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS BLUE SHIELD | 22G83KO | 01 |
| Street Address |
6320 WEDGWOOD RD N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55311-3647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538278791 | Christine Elizabeth Boumann | Physician Assistant | 6320 Wedgwood Rd N, Maple Grove, MN 55311-3647 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609391374 | Deborah Lynn Higgins | Foster Care Agency | 8288 Revelwood Place, Maple Grove, MN 55311 | 2017-08-03 |
| 1013457993 | Trillium Chiropractic & Wellness Pa | Chiropractor | 13700 Reimer Dr Suite 250, Maple Grove, MN 55311 | 2017-02-27 |
| 1720535263 | Fischer Vision PC | Optometrist | 13334 Bass Lake Road North, Maple Grove, MN 55311 | 2016-09-01 |
| 1033571062 | Iman Dadras Konestani | Marriage & Family Therapist | 9325 Garland Lane N Apt 108, Mapple Grove, MN 55311 | 2016-03-29 |
| 1902272685 | Todd Archbold | Social Worker | 18153 80th Pl N, Maple Grove, MN 55311 | 2015-08-17 |
| 1144634395 | Petersen Chiropractic Inc. | Chiropractor | 9505 Blackoaks Ln No., Maple Grove, MN 55311 | 2014-06-16 |
| 1972738276 | Sara Jean Bidler | Marriage & Family Therapist | 7026 E Fish Lake Rd, Maple Grove, MN 55311 | 2009-05-16 |
| 1962670026 | Helminger Chiropractic, P.a. | Chiropractor | 9479 Garland Lane North, Maple Grove, MN 55311 | 2008-02-12 |
| 1457579450 | Cynthia C Cassel | Physician Assistant | 6300 Wedgewood Way, Maple Grove, MN 55311 | 2007-04-23 |
| 1386860732 | Thomas Triden | Chiropractor | 7494 East Fish Lake Road, Maple Grove, MN 55311 | 2007-04-17 |
| Find all providers in zip 55311 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760498414 | Shawn Michael Alderman | Family Medicine | 14500 99th Ave N Ste 100, Maple Grove, MN 55369-5349 | 2006-08-01 |
| 1568453926 | David C Sandell | Family Medicine | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2005-11-03 |
| 1710979489 | Christopher A. Carlson | Family Medicine | 12000 Elm Creek Blvd N, Suite 130, Maple Grove, MN 55369-7073 | 2005-08-18 |
| 1609429646 | Twin Towers, Inc. | Family Medicine | 13700 Reimer Dr N Ste 220, Maple Grove, MN 55311-4548 | 2019-07-18 |
| 1396256392 | Jessica Idahor | Family Medicine | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369 | 2017-10-17 |
| 1841722469 | Brynne Rainier Wilson Latterell | Family Medicine | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2017-04-02 |
| 1114153368 | Moushumi Meher | Family Medicine | 9825 Hospital Drive, Suite 300, Maple Grove, MN 55369 | 2009-06-02 |
| 1417123696 | Anshu Sharma | Family Medicine | 12000 Elm Creek Blvd N, Suite 130, Maple Grove, MN 55369-7073 | 2008-05-07 |
| 1558469858 | John Leighton | Family Medicine | 9825 Hospital Dr, Suite 125, Maple Grove, MN 55369-4479 | 2006-09-20 |
| 1508962440 | Hynatu L Williamson | Family Medicine | 12000 Elm Creek Blvd N, #140, Maple Grove, MN 55369-7073 | 2006-09-16 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55311 |
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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.