Organization
NORTH SUBURBAN UROLOGY OF COON RAPIDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE A HAIKEL MD (PRESIDENT)
(763) 427-3668
Entity
Organization
Contact information
Practice address
3879 COON RAPIDS BLVD, COON RAPIDS, MN 55433
(763) 427-3668
(763) 427-5029
Mailing address
3879 COON RAPIDS BLVD, COON RAPIDS, MN 55433
(763) 427-3668
(763) 427-5029
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
29898
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482780500
—
MN
Enumeration date
04/05/2010
Last updated
04/14/2010
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