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Organization
WAYZATA SURGERY CENTER
Active
Organization
WAYZATA SURGERY CENTER
Active
Parent organization
OMNI MEDICAL CENTER PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OMNI MEDICAL CENTER PLLC
Authorized official
JOHN A NESS MD (PRESIDENT)
(763) 559-4500
Entity
Organization
Contact information
Practice address
935 WAYZATA BLVD E STE 200, WAYZATA, MN 55391-2513
(763) 559-4500
Mailing address
935 WAYZATA BLVD E STE 200, WAYZATA, MN 55391-2513
(763) 559-4500
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
—
NULL
207YS0123X
Facial Plastic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
NULL
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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