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Organization
PEDIATRIC SURGICAL ASSOCIATES LTD
Active
Organization
PEDIATRIC SURGICAL ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL LOUISELLE (EXECUTIVE DIRECTOR)
(612) 813-8006
Entity
Organization
Contact information
Practice address
2530 CHICAGO AVE, SUITE 550, MINNEAPOLIS, MN 55404-4289
(612) 813-8000
(612) 813-8005
Mailing address
4530 W 77TH ST, SUITE 205, EDINA, MN 55435-5006
(952) 835-9442
(952) 835-9443
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
NULL
2086S0120X
Pediatric Surgery Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
NULL
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360710100
—
MN
Enumeration date
04/10/2006
Last updated
04/08/2026
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