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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
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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