Organization
MINNESOTA VASCULAR SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA G. NORBY (EXECUTIVE ASSISTANT/CREDENTIALING)
(763) 398-2203
Entity
Organization
Contact information
Practice address
600 COUNTY ROAD D, NEW BRIGHTON, MN 55112-3519
(763) 432-4300
(763) 432-4301
Mailing address
600 COUNTY ROAD D, NEW BRIGHTON, MN 55112-3519
(763) 432-4300
(763) 432-4301
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508958000
—
MN
Enumeration date
02/09/2007
Last updated
12/17/2012
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