Organization
ECHELON SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW CARROLL CAMP M.D. (CEO)
(507) 383-3134
Entity
Organization
Contact information
Practice address
15450 HIGHWAY 7 STE 225, MINNETONKA, MN 55345-3522
(507) 383-3134
Mailing address
12300 168TH ST W, LAKEVILLE, MN 55044-9224
(507) 383-3134
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
54799
MN
Other
Enumeration date
07/05/2018
Last updated
10/02/2018
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