# MINNESOTA NEONATAL SPECIALISTS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255951190
- **Authorized official:** RICHARD MAKI (BUSINESS MANAGER)
- **Authorized official phone:** (612) 322-6905

## Contact information

- **Practice address:** 9875 HOSPITAL DR, MAPLE GROVE, MN 55369-4648
- **Practice address phone:** (612) 322-6903
- **Mailing address:** 9325 UPLAND LN N STE 360, MAPLE GROVE, MN 55369-4463
- **Mailing address phone:** (612) 322-6903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/21/2020
- **Last updated:** 07/31/2026