Organization
NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN J. KERN M.D. (MEDICAL DIRECTOR)
(763) 981-3200
Entity
Organization
Contact information
Practice address
9855 HOSPITAL DR, STE 175, MAPLE GROVE, MN 55369-4772
(763) 981-3200
(763) 981-3201
Mailing address
9855 HOSPITAL DR, STE 175, MAPLE GROVE, MN 55369-4772
(763) 981-3200
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053442
PREFERRED ONE
—
01
—
1316133044
UCARE
MN
01
—
227637
HEALTH PARTNERS
—
05
—
393688000
—
MN
01
—
5T43MA
BSMN
MN
01
—
68-00092
PATIENT CHOICE
—
Enumeration date
09/17/2007
Last updated
06/21/2018
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