Organization
CENTRAL MINNESOTA ANESTHESIA PROVIDERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE JANDIK M.D. (OWNER)
(320) 492-6506
Entity
Organization
Contact information
Practice address
22415 STATE HIGHWAY 15, SAINT AUGUSTA, MN 56301-9207
(320) 492-6506
Mailing address
PO BOX 7185, SAINT CLOUD, MN 56302-7185
(320) 492-6506
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
38209
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38209
MINNESOTA LICENSE
MN
Enumeration date
02/09/2016
Last updated
06/02/2021
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