Individual
ERIC S NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7373 FRANCE AVE S STE 408, EDINA, MN 55435-4549
(651) 430-3800
(651) 430-3827
Mailing address
1950 NORTHWESTERN AVE S STE 102, STILLWATER, MN 55082-7615
(651) 430-3800
(651) 430-3827
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
40092
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257S0NU
BCBS MN
MN
05
—
684016700
—
MN
Enumeration date
03/02/2006
Last updated
05/24/2024
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