Individual
RUSSELL L WAVRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6545 FRANCE AVE S, STE 540, EDINA, MN 55435-2131
(952) 927-4045
(952) 924-4133
Mailing address
6545 FRANCE AVE S, STE 540, EDINA, MN 55435-2131
(952) 927-4045
(952) 924-4133
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
244196
MN
207VE0102X
Reproductive Endocrinology Physician
244196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055302600
—
MN
01
—
18559WA
BCBS
MN
01
—
HP14652
HEALTHPARTNERS
MN
Enumeration date
03/07/2006
Last updated
04/04/2016
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