South Lake Clinic, PA
NPI 1770914095ActiveOrganization· Pediatrics· Maple Grove, MN
Pediatrics in Maple Grove, Minnesota, registered in NPPES in December 2013. The authorized official on file is Michael Garvis, MD, Medical Director.
Overview
| NPI | 1770914095 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 12, 2013 |
| Last updated in NPPES | Sep 28, 2026 |
| Certified by provider | Sep 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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