1578661534 NPI number — MS. MARILYN ANNE GANJE-FLING M.A.,L.P.

Table of content: MS. MARILYN ANNE GANJE-FLING M.A.,L.P. (NPI 1578661534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578661534 NPI number — MS. MARILYN ANNE GANJE-FLING M.A.,L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANJE-FLING
Provider First Name:
MARILYN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.,L.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578661534
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4839 COLFAX AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55419-5319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-929-1905
Provider Business Mailing Address Fax Number:
952-929-1771

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4500 PARK GLEN RD
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55416-4871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-929-1905
Provider Business Practice Location Address Fax Number:
952-929-1771
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  1330 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC1900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 522K7GA . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 62-54592 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".




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