Michael B Ainslie, M.D.
Individual provider Active NPI Pediatric Endocrinology Physician · St Louis Park, MN
NPI 1114902186 · NPPES record last updated Oct 3, 2011
Key facts
- NPI
- 1114902186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Endocrinology Physician 2080P0205X
- License
- 23228 (MN)
- Practice address
- 3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527 - Phone
- (952) 993-3090
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Endocrinology Physician | 2080P0205X | 23228 | MN | Yes |
Addresses
Primary practice location
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Mailing address
6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 853888300 | Medicaid | MN |
Other providers in St Louis Park, MN
- Rachel L Agneberg
- Kwao Gareth Ahelegbe
- Hadith Yusuf Ahmed
- Sagal Abdiaziz Ahmed
- Seefen Ahmed
- Michael T Akin
- Emolebi Deborah Akpojotor
- Jacob Ari Carter Albersheim
- Aubrianna Alberts
- Chloe Erin Alberts
All providers in St Louis Park, MN · Pediatric Endocrinology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.