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Individual

JAMES H. ANDRISEVIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4570 W 77TH ST, SUITE 235, EDINA, MN 55435-5008
(952) 832-0805
(952) 832-5597
Mailing address
303 E NICOLLET BLVD, SUITE 300, BURNSVILLE, MN 55337-4522
(952) 435-4140
(952) 435-4189

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23231
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112126
UCARE MN
MN
01
138J7AN
BLUECROSS/BLUE SHIELD MN
MN
01
1727004
MEDICA
MN
01
23231
MN LICENSE
MN
01
25107
AMERICA'S PPO
MN
01
961901000016
PREFERREDONE
FM
01
HP12805
HEALTHPARTNERS
MN
Enumeration date
06/20/2006
Last updated
03/07/2023
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