Organization
KOVANDA PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER JOHN KOVANDA M.D. (SOLE MEMBER)
(763) 416-0676
Entity
Organization
Contact information
Practice address
4999 FRANCE AVE S STE 210, EDINA, MN 55410-2168
(612) 335-9032
Mailing address
9325 UPLAND LN N, SUITE 205, MAPLE GROVE, MN 55369-4200
(763) 416-0676
(763) 416-0476
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
41657
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861501082
NPI INDIVIDUAL
—
05
—
852226000
—
MN
Enumeration date
05/08/2009
Last updated
12/10/2019
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