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Organization

NORTHERN OB GYN ASSOCIATES PC

Active
Other names
Northern Ob/Gyn Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN PHILIP WUST III M.D. (PRESIDENT)
(763) 427-8500
Entity
Organization

Contact information

Practice address
3875 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 427-8500
(763) 427-8505
Mailing address
SDS 12 2503, PO BOX 86, MINNEAPOLIS, MN 55486-2503
(763) 427-8500
(763) 427-8505

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
987940000
MN
Enumeration date
08/09/2005
Last updated
05/09/2008
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