GUSTAVE L MELLGREN (NPI# 1871562926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871562926 |
| Entity Type | Individual |
| Full Name | GUSTAVE L MELLGREN |
| Credential | M.D. |
| Practice Address |
10 4th Ave Se Glenwood MN 56334-1820 |
| Practice Telephone | 3206345157 |
| Practice Fax Number | 3206342244 |
| Mailing Telephone | 3206345157 |
| Mailing Fax Number | 3206342244 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2015-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 47727 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 026652300 | 05 | |
| MN | MEDICA | 01-21958 | 01 |
| MN | BCBSMN | 252P5ME | 01 |
| Street Address |
10 4TH AVE SE |
| City | GLENWOOD |
| State | MN |
| Zip Code | 56334-1820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174599641 | Rwanda Darby Campbell | Obstetrics & Gynecology | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2006-02-24 |
| 1568868024 | Dana Lyn Citrowske Lee | Nurse Anesthetist, Certified Registered | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2014-11-11 |
| 1811240336 | Glacial Ridge Health System | Non-Pharmacy Dispensing Site | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2012-10-22 |
| 1417205725 | Glacial Ridge Health System | Non-Pharmacy Dispensing Site | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2012-08-16 |
| 1679861751 | Britta Marie Patterson | Physical Therapist | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2011-07-11 |
| 1760785851 | Kara Diane Mrnak | Registered Nurse | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2010-12-10 |
| 1750616348 | Amy Lynn Brandt | Nurse Practitioner | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2009-10-15 |
| 1700028693 | Erin R Dahlke | Family Medicine | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2009-03-24 |
| 1821242728 | Jenna Nicole Myrom | Nurse Practitioner | 10 4th Ave Se, Glenwood, MN 56334-1820 | 2008-11-05 |
| 1487802021 | Elizabeth Ziemba Colsen | Surgery | 10 4th Ave Se, Glenwood, MN 56334 | 2008-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306206446 | Glacial Ridge Hospital District | Optometrist | 16 West Minnesota Avenue, Suite 102, Glenwood, MN 56334 | 2016-03-02 |
| 1922320142 | Michael David Flaten | Marriage & Family Therapist | 100 17th Ave Nw, Suite #2 Lakeland Mental Health Center, Glenwood, MN 56334 | 2010-02-16 |
| 1427107721 | G E Maher Ltd | Dentist | 101 First Avenue Sw, Glenwood, MN 56334 | 2007-01-09 |
| 1740340256 | Jeremy Myrom | Dentist | 1616 N Franklin St, Glenwood, MN 56334 | 2006-12-12 |
| 1144380627 | Scott William Ringdahl | Dentist | 1616 N Franklin Str, Glenwood, MN 56334 | 2006-12-12 |
| 1225258247 | Dental Health Services Minnewaska Pllc | Dentist | 1616 N Franklin Str, Glenwood, MN 56334 | 2007-05-01 |
| 1194968750 | Gerald Edward Maher | Dentist | 101 First Ave Sw, Glenwood, MN 56334-0174 | 2009-04-13 |
| 1548444243 | Jean Marie Mcdermott | Case Manager/Care Coordinator | 102 1st St Ne, #2, Glenwood, MN 56334-1201 | 2007-12-18 |
| 1487032926 | Charline Bengtson | Marriage & Family Therapist | 105 2nd Ave Ne Ste 110, Glenwood, MN 56334-1226 | 2015-05-18 |
| 1982115390 | Charline Bengtson LLC | Community/Behavioral Health | 105 2nd Ave Ne Ste 110, Glenwood, MN 56334-1226 | 2017-10-12 |
| Find all providers in zip 56334 | ||||
| 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 |
|---|---|---|---|---|
| 1043434525 | Robert Marvin Kent | Family Medicine | 1203 S Locust St, Glenwood, IA 51534-1872 | 2007-04-13 |
| 1649285172 | Glacial Ridge Hospital District | Family Medicine | 417 Franklin St S, Glenwood, MN 56334-1518 | 2006-07-31 |
| 1275573750 | Matthew D Hulsey | Family Medicine | 248 Highway 70 E, Suite A, Glenwood, AR 71943-8801 | 2006-06-07 |
| 1467441584 | Mark Griffis | Family Medicine | 111 North 3rd St, Glenwood, GA 30428-9004 | 2005-10-20 |
| 1992704217 | Michelle Meeks | Family Medicine | 19310 S Halsted St, Glenwood, IL 60425 | 2005-07-19 |
| 1912902404 | Robert Kenneth Fryzek | Family Medicine | Po Box 69, Glenwood, IA 51534-0069 | 2005-06-20 |
| 1609870948 | Michael Dale Schmiesing | Family Medicine | 320 Ebaugh St, Glenwood, IA 51534-1811 | 2005-06-01 |
| 1821622838 | Circles Healthcare | Family Medicine | 2480 Roxbury Mills Rd Ste 10, Glenwood, MD 21738-9718 | 2020-02-28 |
| 1609317387 | Mohammed Adnan | Family Medicine | 19310 S Halsted St, Glenwood, IL 60425-1562 | 2017-03-15 |
| 1760831648 | Samer Shaja | Family Medicine | 19310 S Halsted St, Glenwood, IL 60425-1562 | 2016-06-10 |
| Find all providers in GLENWOOD | ||||
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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.