Eagle Medical PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14736 Issued in MN

Legal business name

EAGLE MEDICAL PA

Practice address

490 Oak St
Excelsior, MN 55331-3002

Phone

(952) 474-4167

Fax

(952) 474-5700

NPI assigned

Sep 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Milton Henry Seifert Jr., M.D.

Title

Ceo, Owner

Phone

95247474167

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Swarna Erramreddi Latha, M.D

  • Family Medicine Physician
  • Excelsior, MN
  • NPI 1912013954
  NPD (past)
• Michele D Strachan, MD

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1013098243
  NPD (past)
• Daniela Tank, D.O.

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1841277837
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225138399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 OAK ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313002",
            "telephone_number": "952-474-4167",
            "fax_number": "952-474-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 OAK ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313002",
            "telephone_number": "952-474-4167",
            "fax_number": "952-474-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEIFERT",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "95247474167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "14736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Deitering
• Mallori Beth Dombrock, D.C.
• Bryan Dorn, DPT
• Hillary Duarte
• Rhea Marie Dykoski, L.AC., DIPL.O.M.
• Virginia G Ehrman, LP
• Irene Enjema Ekobena, NP
• Empower Chiropractic and Wellness Center P.L.L.C.
• Brian Entinger, PHARM. D.
• Estates at Excelsior LLC

• Family Medicine Physician in Excelsior, MN
• Providers in Excelsior, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.