Organization
WESTERN ORTHOPAEDIC SURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOLAN M. SEGAL M.D. (PRESIDENT)
(763) 694-2977
Entity
Organization
Contact information
Practice address
6490 EXCELSIOR BLVD, W-417, ST LOUIS PARK, MN 55426-4705
(763) 694-2977
Mailing address
5100 GAMBLE DR, SUITE 540, ST LOUIS PARK, MN 55416-1521
(763) 694-2977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22951
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03388DA
BLUE CROSS BLUE SHIELD MN
MN
01
—
0929927
MEDICA
MN
05
—
271210500
—
MN
01
—
C808
UCARE
MN
Enumeration date
05/18/2006
Last updated
08/22/2020
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