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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
2086S0122X
Plastic and Reconstructive Surgery Physician
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
11/09/2020
Last updated
11/09/2020
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