Individual
DR. STEVEN JAMES WAISBREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9325 UPLAND LN N, SUITE 205, MAPLE GROVE, MN 55369-4470
(763) 416-0676
(763) 416-0476
Mailing address
9325 UPLAND LN N, SUITE 205, MAPLE GROVE, MN 55369-4470
(763) 416-0676
(763) 416-0476
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39606
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634019900
—
MN
Enumeration date
06/28/2006
Last updated
01/08/2008
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