Healthcare Provider Details

I. General information

NPI: 1275684128
Provider Name (Legal Business Name): SUMMIT ORTHOPEDICS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 SAINT ANTHONY AVE
SAINT PAUL MN
55104-7633
US

IV. Provider business mailing address

710 COMMERCE DR STE 200
WOODBURY MN
55125-4925
US

V. Phone/Fax

Practice location:
  • Phone: 651-968-5300
  • Fax: 651-646-0205
Mailing address:
  • Phone: 651-968-5042
  • Fax: 651-968-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN BIEN
Title or Position: CFO
Credential:
Phone: 651-968-5870