Healthcare Provider Details
I. General information
NPI: 1710693320
Provider Name (Legal Business Name): MINNESOTA ANESTHESIA SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1447 WHITE OAK DR
CHASKA MN
55318-2525
US
IV. Provider business mailing address
1447 WHITE OAK DR
CHASKA MN
55318-2525
US
V. Phone/Fax
- Phone: 952-368-3800
- Fax: 952-361-9499
- Phone: 952-368-3800
- Fax: 952-361-9499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SARA
BHATTI
Title or Position: ASC OPERATIONS MANAGER
Credential: RN, BSN
Phone: 952-368-3800