Revive MD PLLC
Revive MD PLLC is a Family Medicine Physician in Saint Paul, Minnesota. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 3
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
821 Raymond Ave Ste 230Saint Paul, MN 55114-1503
Phone: (651) 746-4412
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Interventional Pain Medicine Physician (primary) | Taxonomy 208VP0014X |
|---|---|
| Family Medicine Physician | Taxonomy 207Q00000X |
| Substance Use Disorder Rehabilitation Clinic/Center | Taxonomy 261QR0405X |
Record details
| NPI number | 1346832953 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Alfonso Morales — Owner · (651) 476-4412 |
| NPI enumerated | February 4, 2021 |
| Last updated in NPPES | February 4, 2021 |
| Certification date | February 4, 2021 |
| Mailing address | 7595 Currell Blvd Unit 25404, Woodbury, MN 55125-2569 |
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William Oliver Roberts, MD
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Daniel Rosenbush, DO
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