Individual
DR. CRAIG STUART WALVATNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11855 ULYSSES ST NE, 220, BLAINE, MN 55434-3947
(763) 427-8547
(763) 576-5394
Mailing address
3887 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 427-8547
(763) 576-5394
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
27345-020
WI
208600000X
Surgery Physician
31967
MN
2086S0102X
Surgical Critical Care Physician
27345-020
WI
2086S0102X
Surgical Critical Care Physician
31967
MN
2086S0129X
Vascular Surgery Physician
Primary
31967
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1778251
—
MN
01
—
301T6WA
BCBS
MN
05
—
476753500
—
MN
01
—
HSZ009
MEDICARE GRP B
MN
Enumeration date
08/13/2006
Last updated
07/29/2025
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