# MINNESOTA ORTHOPAEDIC SURGERY CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1972553741
- **Authorized official:** DR. PETER D HOLMBERG M.D. (PRESIDENT)
- **Authorized official phone:** (763) 786-9543

## Contact information

- **Practice address:** 8290 UNIVERSITY AVE NE, SUITE 100, FRIDLEY, MN 55432-1847
- **Practice address phone:** (763) 786-0461
- **Practice address fax:** (763) 786-0471
- **Mailing address:** 8290 UNIVERSITY AVE NE, SUITE 100, FRIDLEY, MN 55432-1847
- **Mailing address phone:** (763) 717-4105
- **Mailing address fax:** (952) 456-7092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | HFID\#04305 | MN | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 08/03/2016