Healthcare Provider Details

I. General information

NPI: 1245446079
Provider Name (Legal Business Name): MINNEAPOLIS SURGICAL CTR ANESTHESIOLOGISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 FRANCE AVE S
EDINA MN
55435-2104
US

IV. Provider business mailing address

19029 YALE CIR NW
ELK RIVER MN
55330-2876
US

V. Phone/Fax

Practice location:
  • Phone: 52-925-5196
  • Fax:
Mailing address:
  • Phone: 612-441-0669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN BRZICA
Title or Position: SENIOR PARTNER
Credential: MDA
Phone: 612-441-0669