Thresiamma Augustine Joseph
Adolescent Medicine
3585 Lexington Ave N Ste 350
Shoreview
, Minnesota 55126-8064
Thresiamma Augustine Joseph
Adolescent Medicine
3585 Lexington Ave N Ste 350
Shoreview
, Minnesota 55126-8064
(651) 251-5282
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Thresiamma Augustine Joseph
- 3585 Lexington Ave N Ste 350
- Shoreview, MN
- Zip : 55126-8064
- Fax : (651) 251-5282
- Phone : (651) 251-5280
Second Address
- Thresiamma Augustine Joseph
- 3585 Lexington Ave N Ste 350
- Shoreview, MN
- Zip : 55126-8064
- Fax : (651) 787-0519
- Phone : (651) 484-3942
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 32036 | MN |
National Provider Identifier
| NPI | 1144214107 |
|---|---|
| Provider Name | Thresiamma Augustine Joseph |
| First Address | Shoreview, MN 55126-8064 |
| Second Address | Shoreview, MN 55126-8064 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/09/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1201379 | MEDICA (01) | MN |
| 1203070 | MEDICA (01) | MN |
| 299L3J0 | BLUE CROSS BLUE SHEILD (01) | MN |
| A96960 | (02) | |
| CP9090199004 | PREFERRED ONE (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.