Organization
MINNESOTA NEUROVASCULAR & SKULL BASE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC S NUSSBAUM MD (OWNER)
(612) 374-0177
Entity
Organization
Contact information
Practice address
3033 EXCELSIOR BLVD, SUITE 403, MINNEAPOLIS, MN 55416-4688
(612) 374-0177
(612) 374-0893
Mailing address
3901 W 25TH ST, SAINT LOUIS PARK, MN 55416-3803
(952) 285-1016
(952) 285-1018
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21266300
—
WI
05
—
77007040
—
SD
Enumeration date
04/04/2007
Last updated
03/27/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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