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Organization

MONTICELLO-BIG LAKE ANESTHESIOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY FRIESEN (CFO)
(763) 271-2303
Entity
Organization

Contact information

Practice address
1013 HART BLVD, MONTICELLO, MN 55362-8575
(763) 271-2303
(763) 295-4593
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111217
HEALTHPARTNERS
MN
01
136709
UCARE/MANAGED CARE
MN
01
302G4MO
BLUE CROSS OF MN
MN
Enumeration date
05/31/2006
Last updated
04/29/2008
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